Chilaiditi's syndrome in a patient under long-term antidepressants- A case report

INTRODUCTION: Chilaiditi's sign is a rare radiological sign characterized by interposition of the colon between diaphragm and liver. It is called Chilaiditi's syndrome if the patient presents with associated symptoms. Its diagnosis is incidental and can be confused with other acute conditions. CASE PRESENTATION: This is a case of 85-year-old gentleman who presented with complaints of epigastric pain and vomiting. The patient had a history of long-term antidepressant medications. X-ray of chest and abdomen revealed presence of bowel loops under the diaphragm. CT scan helped confirm the diagnosis of Chilaiditi's sign. DISCUSSION: Chilaiditi's sign has a low prevalence on chest and abdominal X-rays. Common associated symptoms include abdominal pain, nausea, vomiting and constipation. It can be misdiagnosed as bowel perforation and can lead to unnecessary surgical interventions. Symptomatic patients are managed conservatively. CONCLUSION: Chilaiditi's syndrome is a rare radiological entity and should be diagnosed carefully to avoid unwanted surgical procedures.