Chilaiditi' Syndrome: A Case Report

Chilaiditi氏症候群個案報告

洪順世(Shuh-Shih Hung) ； 許宗鴻(Choon-Hoon Hii)

《弘光學報》 79期 (2017/03) Pp. 61-66

https://doi.org/10.6615/HAR.201703.79.05

摘要

Chilaiditi's sign, a radiographic finding of hepatodiaphragmatic interposition of bowel, is found in asymptomatic patients and must be distinguished from Chilaiditi's syndrome, which produces symptoms associated with the bowel interposition. It is important to distinguish Chilaiditi's syndrome from other significant pathological conditions which may lead to unnecessary laparotomy. We presented a case of chilaiditi's syndrome which simulated pneumoperitoneum in a dementia patient, along with a discussion of diagnosis and treatment related to this entity.

並列摘要

Chilaiditi氏症候群(橫膈下結腸嵌入綜合徵)主要是指在放射學上發現腸管錯置在肝臟及右半橫膈膜之間，且合併有臨床症狀如腹痛、便秘、嘔吐、食欲不振、呼吸窘迫、心律不整等。發生率占胸片的0.025%– 0.28%。造成此症的相關因素有結腸冗長；異常的膈肌膨升，如膈疝或膈肌麻痹；肝臟縮小，如肝硬化；鐮狀韌帶異常等。Chilaiditi氏症候群的重要性在於其與腹腔積氣相似，而確定是否存在膈下游離氣體非常重要。前者絕大部份病人如本文之個案一樣只須接受保守治療即可痊癒而存在膈下游離氣體則常須剖腹手術。 應用各種體位，如立位或左側臥位腹部平片及腹部超音波有助於鑒別診斷；有時則需要CT掃描來確定診斷特別是懷疑Chilaiditi氏症候群合併腹腔積氣時。正確診斷Chilaiditi氏症候群則可避免病人接受不必要的手術。

並列關鍵字

腹腔積氣

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