Chilaiditi Syndrome Caused by Fitz-Hugh-Curtis: Ultrasound and Computed Tomography Findings

IF 1.3 4区医学 Q3 EMERGENCY MEDICINE

Journal of Emergency Medicine Pub Date : 2025-07-08 DOI:10.1016/j.jemermed.2025.07.023

Colm Michael Mulvany MD , Andrew Nguyen MD , Sarah Bella DO

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引用次数: 0

Abstract

Background

Chilaiditi Syndrome (CS) is the entrapment of the small bowel or colon between the liver and right hemidiaphragm. Risk factors include anatomical distortions of the right upper quadrant, such as adhesions from the anterior hepatic capsule.

Case Report

A 50-year-old female with no prior surgical history presented to our emergency department (ED) complaining of right upper quadrant pain. Point of care ultrasound (POCUS) findings were concerning for a bowel obstruction. Contrast-enhanced computed tomography (CT) abdomen and pelvis demonstrated incarcerated small bowel loops into the hepatodiaphragmatic space characteristic of CS and on subsequent laparoscopy adhesions characteristic of Fitz-Hugh-Curtis Syndrome (FHCS) were identified and lysed.

Why Should an Emergency Physician Be Aware of This

This case demonstrates the utility of POCUS in visualizing a rare form of bowel obstruction and in identifying CS, in this instance secondary to FHCS.

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由Fitz-Hugh-Curtis引起的Chilaiditi综合征：超声和计算机断层扫描结果

背景chilaiditi综合征（CS）是指小肠或结肠在肝和右膈之间的卡压。危险因素包括右上象限的解剖扭曲，如肝前囊的粘连。病例报告：一名50岁女性，无手术史，以右上腹疼痛就诊于急诊科。护理点超声（POCUS）的结果是有关肠梗阻。腹部和骨盆对比增强计算机断层扫描（CT）显示嵌顿小肠袢进入肝膈间隙，这是CS的特征，随后的腹腔镜检查发现并分析了Fitz-Hugh-Curtis综合征（FHCS）的粘连特征。急诊医生为什么要注意这一点？本病例展示了POCUS在一种罕见的肠梗阻的显像和CS的识别上的应用，该病例继发于FHCS。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Emergency Medicine 医学-急救医学

CiteScore

2.40

自引率

6.70%

发文量

339

审稿时长

2-4 weeks

期刊介绍： The Journal of Emergency Medicine is an international, peer-reviewed publication featuring original contributions of interest to both the academic and practicing emergency physician. JEM, published monthly, contains research papers and clinical studies as well as articles focusing on the training of emergency physicians and on the practice of emergency medicine. The Journal features the following sections: • Original Contributions • Clinical Communications: Pediatric, Adult, OB/GYN • Selected Topics: Toxicology, Prehospital Care, The Difficult Airway, Aeromedical Emergencies, Disaster Medicine, Cardiology Commentary, Emergency Radiology, Critical Care, Sports Medicine, Wound Care • Techniques and Procedures • Technical Tips • Clinical Laboratory in Emergency Medicine • Pharmacology in Emergency Medicine • Case Presentations of the Harvard Emergency Medicine Residency • Visual Diagnosis in Emergency Medicine • Medical Classics • Emergency Forum • Editorial(s) • Letters to the Editor • Education • Administration of Emergency Medicine • International Emergency Medicine • Computers in Emergency Medicine • Violence: Recognition, Management, and Prevention • Ethics • Humanities and Medicine • American Academy of Emergency Medicine • AAEM Medical Student Forum • Book and Other Media Reviews • Calendar of Events • Abstracts • Trauma Reports • Ultrasound in Emergency Medicine