Chilaiditi syndrome: sonographic findings

BACKGROUND AND METHODS: Sonographic (US) findings of Chilaiditi syndrome have been rarely reported in the literature. We reviewed 18 cases of Chilaiditi syndrome to pinpoint its US pattern. RESULTS: (1) US showed gas echoes of different sizes superimposed over the entire liver in two cases and over the right hepatic lobe in six cases, leading to a high suspicion of Chilaiditi syndrome. (2) US showed a small gas echo in the hepatodiaphragmatic space, mimicking pneumoperitoneum in eight cases. In this instance, altering the patient's position allowed for confirmation of the lack of a change in the location of the gas echo, unlike cases of pneumoperitoneum. (3) The hepatic surface appeared as a hyperechoic mass in two cases. CONCLUSION: Knowledge of US patterns of Chilaiditi syndrome helps avoid confusion with pneumoperitoneum or hepatic masses.