Two Cases of Chilaiditi Syndrome: Symptomatic and Asymptomatic Presentation

Chilaiditi syndrome or sign is mostly asymptomatic but rarely presents with gastrointestinal symptoms. Air under the right hemidiaphragm, which is a sign of the syndrome on direct X-ray, may suggest many acute abdominal etiologies. Both the haustral structures formed by the folds and visualization of the interposition of the colon between the liver and the right hemidiaphragm on computed tomography confirm the Chilaiditi sign. In this article, we present two cases of Chilaiditi, a symptomatic elderly patient with gastrointestinal complaints during hospitalization, and an asymptomatic youth person. This sign, which is one of the differential diagnoses of air under the right hemidiaphragm in X-ray, is aimed to attract the attention of clinicians to protect the patient from unnecessary interventional procedures as a requirement of the quaternary prevention principle. Lifestyle changes and medical treatments for complaints were recommended in both cases, and no surgical procedure was performed.