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01-07-2015 | Original Article

Anterior hepatic grooves accompanied by Chilaiditi sign: a retrospective radiological analysis of a neglected anatomical fact

Authors: Alpaslan Yavuz, Abdussamet Batur, Mehmet Deniz Bulut, Aydin Bora, Cemil Göya, Cagatay Andic, Mehmet Beyazal, Sehmus Olmez

Published in: Surgical and Radiologic Anatomy | Issue 5/2015

Abstract

Purpose

To evaluate anterior hepatic grooves (AHGs) associated with hepato-diaphragmatic mesocolic indentations (Chilaiditi sign) and to delineate the incidence and potential clinical significance of this association.

Methods

Between November 2011 and June 2014, abdominal computed tomography examinations of 2,314 patients with varied indications were retrospectively reviewed. Patients were surveyed consecutively for the Chilaiditi sign and syndrome, and cases with grooves at the antero-inferior hepatic surface enclosing the adjacent mesocolic indents were determined. The incidence of AHGs and their predominance by gender and age were determined. The potential clinical significance of AHGs associated with Chilaiditi syndrome and their possible effect on liver volume were assessed.

Results

The incidences of AHGs were similar between genders (p = .461 and p = .646) and age (p = .113 and .621, respectively) among total cohort and patients with Chilaiditi sign, respectively. There was no significant correlation between AHGs and Chilaiditi syndrome (p = .506); no efficacies of AHGs to liver volume were assessed (p = .413).

Conclusions

The AHGs are rare adaptive changes in shape of the liver without a significant effect on liver volume. This overlooked phenomenon is likely derived from the Chilaiditi sign, but has no significant correlation with Chilaiditi syndrome. Future studies with extended series are encouraged to reveal the possible significance of this phenomenon based on concerned surgical interventions.

Altomare DF, Rinaldi M, Petrolino M, Sallustio PL, Guglielmi A, Pannarale OC (2001) Chilaiditi’s syndrome. Successful surgical correction by colopexy. Tech Coloproctol 5:173–175. doi:10.1007/s101510100022 CrossRefPubMed

Alva S, Shetty-Alva N, Longo WE (2008) Image of the month. Chilaiditi sign or syndrome. Arch Surg 143:93–94. doi:10.1001/archsurg.2007.12-a CrossRefPubMed

Angulo Cuesta J, Gonzalez Zorraquino A, Unda Urzaiz M, Flores Corral N (1991) Chilaiditi syndrome in the differential diagnosis of renal colic. Arch Esp Urol 44:300–301PubMed

Barbaro B, Soglia G, Alvaro G, Vellone M, Giuliante F, Nuzzo G, Bonomo L (2013) Hepatic veins in presurgical planning of hepatic resection: what a radiologist should know. Abdom Imaging 38:442–460. doi:10.1007/s00261-012-9900-8 CrossRefPubMed

Bassan MS, Thomson A (2008) Education and imaging. Gastrointestinal: chilaiditi syndrome. J Gastroenterol Hepatol 23:499. doi:10.1111/j.1440-1746.2008.05336.x CrossRefPubMed

Baumer F, Weber P, Horl M (1988) The Chilaiditi syndrome as a cause of acute abdomen. Zentralbl Chir 113:1415–1418PubMed

Behlke FM (1964) Hepatodiaphragmatic interposition in children. Am J Roentgenol Radium Ther Nucl Med 91:669–673PubMed

Bora A, Alptekin C, Yavuz A, Batur A, Akdemir Z, Berkoz M (2014) Assessment of liver volume with computed tomography and comparison of findings with ultrasonography. Abdom Imaging. doi:10.1007/s00261-014-0146-5 PubMed

Campana L (1992) What is your roentgen diagnosis? Hepatodiaphragmatic interposition of the right colonic flexure, Chilaiditi syndrome in dolichocolon. Schweiz Rundsch Med Prax 81:813–814PubMed

10.

Chang CH, Yu CH, Chang FM, Ko HC, Chen HY (2003) The assessment of normal fetal liver volume by three-dimensional ultrasound. Ultrasound Med Biol 29:1123–1129CrossRefPubMed

11.

Chilaiditi D (1910) Zur Frage der Hepatoptose und Ptose im allegemeinen im Anschluss an drei Fallevon temporarer, partieller Leberverlagerung. Fortschr Geb Rontgenstr Nuklearmed Erganzungsband 16:173–208

12.

Couinaud C (1999) Liver anatomy: portal (and suprahepatic) or biliary segmentation. Dig Surg 16:459–467CrossRefPubMed

13.

De Cecco CN, Ferrari R, Rengo M, Paolantonio P, Vecchietti F, Laghi A (2009) Anatomic variations of the hepatic arteries in 250 patients studied with 64-row CT angiography. Eur Radiol 19:2765–2770. doi:10.1007/s00330-009-1458-7 CrossRefPubMed

14.

Dogu F, Reisli I, Ikinciogullari A, Fitoz S, Babacan E (2004) Unusual cause of respiratory distress: chilaiditi syndrome. Pediatr Int 46:188–190. doi:10.1046/j.1442-200x.2004.01856.x CrossRefPubMed

15.

Fuessl HS (2003) Angina, dyspnea and constipation. Hepato-diaphragmatic interposition of the colon (Chilaiditi syndrome). MMW Fortschr Med 145:53–54

16.

Geraghty EM, Boone JM, McGahan JP, Jain K (2004) Normal organ volume assessment from abdominal CT. Abdom Imaging 29:482–490. doi:10.1007/s00261-003-0139-2 CrossRefPubMed

17.

Gurvits GE, Lau N, Gualtieri N, Robilotti JG (2009) Air under the right diaphragm: colonoscopy in the setting of Chilaiditi syndrome. Gastrointest Endosc 69:758–759. doi:10.1016/j.gie.2008.12.238 (discussion 759)

18.

Iezzi R, Cotroneo AR, Giancristofaro D, Santoro M, Storto ML (2008) Multidetector-row CT angiographic imaging of the celiac trunk: anatomy and normal variants. Surg Radiol Anat 30:303–310. doi:10.1007/s00276-008-0324-7 CrossRefPubMed

19.

Orangio GR, Fazio VW, Winkelman E, McGonagle BA (1986) The Chilaiditi syndrome and associated volvulus of the transverse colon. An indication for surgical therapy. Dis Colon Rectum 29:653–656CrossRefPubMed

20.

Prassopoulos PK, Raissaki MT, Gourtsoyiannis NC (1996) Hepatodiaphragmatic interposition of the colon in the upright and supine position. J Comput Assist Tomogr 20:151–153CrossRefPubMed

21.

Torgersen J (1951) Suprahepatic interposition of the colon and volvulus of the cecum. Am J Roentgenol Radium Ther 66:747–751PubMed

22.

Williams A, Cox R, Palaniappan B, Woodward A (2014) Chilaiditi’s syndrome associated with colonic volvulus and intestinal malrotation-A rare case. Int J Surg Case Rep 5:335–338. doi:10.1016/j.ijscr.2014.03.011 CrossRefPubMedCentralPubMed

23.

Yin AX, Park GH, Garnett GM, Balfour JF (2012) Chilaiditi syndrome precipitated by colonoscopy: a case report and review of the literature. Hawaii J Med Public Health 71:158–162PubMedCentralPubMed

Title: Anterior hepatic grooves accompanied by Chilaiditi sign: a retrospective radiological analysis of a neglected anatomical fact
Authors: Alpaslan Yavuz
Abdussamet Batur
Mehmet Deniz Bulut
Aydin Bora
Cemil Göya
Cagatay Andic
Mehmet Beyazal
Sehmus Olmez
Publication date: 01-07-2015
Publisher: Springer Paris
Published in: Surgical and Radiologic Anatomy / Issue 5/2015
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI: https://doi.org/10.1007/s00276-015-1443-6

At a glance: The STEP trials

Springer Medicine

Anterior hepatic grooves accompanied by Chilaiditi sign: a retrospective radiological analysis of a neglected anatomical fact

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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