Hepatodiaphragmatic Interposition of the Intestine (Chilaiditi's Syndrome)

肝－橫膈間位性腸道（奇來黛堤氏症候群）

張天祐(Tein-Yow Chang) ； 刁翠美(Chui-Mei Tiu) ； 周宜宏(Yi-Hong Chou) ； 黃麗玲(Li-Ling Huang) ； 于俊(Chun Yu)

《中華放射線醫學雜誌》 24卷3期 (1999/06) Pp. 101-105

摘要

奇來黛堤氏症候群是肝－橫膈間位性腸道的其中一型。在西方國家並不常見，而有關國人中此症候群的罹病率亦付闕如，故本文嘗試探討其就單一醫學中心之罹病率，並覆閱此症候群在放射線以及超音波影像上的表現。
我們連續覆閱－醫學中心之2358位受檢者之胸部X光片。一旦發現有肝－橫膈間位性腸道的病例，則詳細分析該病例之各項臨床資料。若病人同時曾接受過腹部超音波檢查，則再進一步分析超音波影像。
此2358個案例包括978例女性及1380例男性，其中共有9位男性（罹病率0.38%）出現前位型肝－橫膈間位性腸道［即奇來黛堤氏症候群］。這9位病例中的5位曾有消化系統疾病，而且其中的3位在出現肝一橫膈間位性腸道的同時，也有腸胃道症狀。雖然，只有3位病人曾接受腹部超音波檢查，但都有獨特的表徵。
本研究發現肝－橫膈間位性腸道的罹病率為0.38%，較西方國家所報告之發生率為高。而且奇來黛堤氏症候群在傳統胸部x光影像有其典型的表徵，但若非典型時，超音波影像、鋇劑攝影或電腦斷層攝影的表現也可概略與氣腹、橫膈下膿瘍以及橫膈疝氣做區別。一般來說，肝－橫膈間位性腸道並無病理學上的重要性。

關鍵字

奇來黛堤氏症候群 ； 胸腔，放射線攝影 ； 胃腸道，異常 ； 胃腸道，超音波

並列摘要

Chilaiditi's syndrome is one type of hepatodiaphragmatic interposition of the intestine (HDI) and is infrequently seen in Western countries.
The purpose of this article is to present the prevalence of HDI in a medical center and the roentgenographic and sonographic findings of this syndrome.
We reviewed a series of chest roentgenograms of 2358 consecutive patients at Veterans General Hospital-Taipei. If the patient had HDI, the medical chart was reviewed. In patients with HDI who had also received abdominal sonographic study, we analyzed the images again.
Nine males out of these 2358 consecutive patients (0.38%) had Chilaiditi's syndrome. All nine patients had anterior HDI with interposition of the hepatic flexure of the colon temporarily. The interposition was not seen on the follow-up chest roentgenograms of the nine patients. There were five patients with HDI who had digestive system diseases and three of them had gastrointestinal upset during the presence of HDI. Abdoniinal sonograms were performed on three of the nine patients with HDI and revealed distinguishable findings.
The prevalence of HDI in our study was 0.38%, which is higher than that in Western countries. The roentgenographic findings in patients with HDI is distinct. HDI generally has no pathological significance.

並列關鍵字

Chilaiditi's syndrome ； Thorax, radiography ； Gastrointestinal tract, abnormalities ； Gastrointestinal tract, US