Accidentally Case of Chilaiditi’s Syndrome in COVID-19 Geriatric Patient

Vesri Yoga, M. Abdullah, Arnelis Arnelis
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Abstract

Chilaiditi’s syndrome is a rare disease with an incidence of 0.025-0.28% cases, where it shows colon interposition between diaphragm and right lobe of liver. Usually related to congenital malformation include the absence, weakness, or elongation of suspensory ligaments of transversal colon or falciform ligaments. The 83-year-old woman was admitted with 1-week history of fatigue, lacked the will to eat and drink. Nausea and vomiting were sometimes accompanied with abdominal pain. Patient often had difficulty in defecating even though she had been eating fruits, she often needed laxatives. Patient had a history of osteoarthritis and hypertension.Physical examination appeared moderately-ill, with gasglow coma scale (GCS) 14 and blood pressure 150/90 mmHg. From abdomen epigastric tenderness (+). From thoracic X-ray found visible interposition of colon at right-upper quadrant of abdomen. Geriatric index fall risk assessment = 11 and mini mental state examination (MMSE) = 22. This patient was a geriatric patient with multiple diagnosis and frailty. Patient had a history of osteoarthritis contributes to patient’s instability. Chronic constipation was also quite disturbing cause an interposition of colon. Patient had coincidence with COVID-19 with comorbidity and geriatric syndrome. Thorough care, close monitoring, and optimal management should be applied.
新冠肺炎老年患者奇拉迪提综合征意外病例
Chilaiditi综合征是一种罕见的疾病,发病率为0.025-0.28%,表现为横膈与肝右叶之间的结肠间质。通常与先天性畸形有关的包括横结肠悬韧带或镰状韧带的缺失、无力或伸长。患者83岁,入院时有1周的疲劳史,缺乏饮食意愿。恶心、呕吐有时伴有腹痛。病人经常排便困难,即使她一直吃水果,她经常需要泻药。患者有骨关节炎和高血压病史。体格检查表现为中度疾病,气晕昏迷评分(GCS) 14分,血压150/90 mmHg。腹部上腹部压痛(+)。胸部x线显示腹部右上象限可见结肠间置。老年指数跌倒风险评估= 11,迷你精神状态检查(MMSE) = 22。该患者是一名多重诊断和虚弱的老年患者。患者有骨关节炎史,导致患者不稳定。由于结肠的介入,慢性便秘也很令人不安。患者与新冠肺炎合并合并症和老年综合征符合。应采取彻底护理、密切监测和最佳管理。
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