Psychiatric patient with Chilaiditi's syndrome.

Q4 Medicine
P Vasileiadis, G Mavridis, A Keramidas, D Chardalidou, I Pervos, C Charalampous
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引用次数: 0

Abstract

Background: Chilaiditi's sign is defined as the interposition of bowels between the liver and the right diaphragm. When the patient is symptomatic due to the intestinal obstruction, the case is referred to as Chilaiditi's syndrome.

Objective: To emphasize the importance of accurate diagnose of Chilaiditi's syndrome in patients with psychotic disturbances.

Method: A 46 years old male was admitted to our department suffering from a constant epigastric and right upper quadrant pain with radiation to the right shoulder. The pain started 10 hours before the admission of the patient and was accompanied with vomiting. Patient has a history of schizophrenia and intellectual disability. He was in a stimulatory situation and unable to give any information about his state of health.

Results: Patient was afebrile, tachycardic and laboratory results were normal. The chest and abdomen x-ray showed the Chilaiditi's sign. With the ultrasound procedure the case of the pneumoperitoneum was excluded. A conservative treatment with IV fluid hydration, pain management, diet modification, laxatives and enemas, was used. After a week of hospitalization, the patient felt well, having proper diet and regular evacuations and at the Chilaiditi's sign was no more observed.

Discussion: The etiology of the Chilaiditi's syndrome is multifactoral and it has been reported that it is associated with psychotropic medication and intellectual disability.

Conclusions: The diagnosis of the syndrome is vital in order to avoid unnecessary and dangerous surgical interventions. Only few publications of a Chilaiditi syndrome in patients with psychosis are cited in the literature.

患有奇莱迪蒂综合征的精神病患者。
背景介绍Chilaiditi征被定义为肠道位于肝脏和右膈之间。当患者因肠梗阻而出现症状时,这种病例被称为 Chilaiditi 综合征:强调准确诊断 Chilaiditi's 综合征对精神病患者的重要性:一名 46 岁男性因持续上腹部和右上腹疼痛并向右肩放射而入住我科。疼痛开始于入院前 10 小时,并伴有呕吐。患者有精神分裂症和智力障碍病史。他当时处于受刺激状态,无法提供任何有关其健康状况的信息:结果:患者无发热、心动过速,化验结果正常。胸部和腹部 X 光片显示奇莱迪蒂征。超声波检查排除了腹腔积气的可能。患者接受了静脉输液、止痛、调整饮食、通便和灌肠等保守治疗。住院一周后,患者感觉良好,饮食合理,排便规律,Chilaiditi 征不再出现:讨论:奇莱迪蒂综合征的病因是多因素的,有报道称它与精神药物和智力障碍有关:结论:对该综合征的诊断至关重要,可避免不必要且危险的手术干预。关于精神病患者的 Chilaiditi 综合征,文献中仅有极少数报道。
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来源期刊
Clinical Schizophrenia and Related Psychoses
Clinical Schizophrenia and Related Psychoses Medicine-Psychiatry and Mental Health
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期刊介绍: The vision of the exciting new peer-reviewed quarterly publication Clinical Schizophrenia & Related Psychoses (CS) is to provide psychiatrists and other healthcare professionals with the latest research and advances in the diagnosis and treatment of schizophrenia and related psychoses. CS is a practice-oriented publication focused exclusively on the newest research findings, guidelines, treatment protocols, and clinical trials relevant to patient care.
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