An Incidental Finding of Chilaiditi's Sign: A Case Report

Abstract

Chilaiditi’s Sign is a rare radiographic finding in which there is an interposition of the colon between the diaphragm and the liver. The etiology is multifactorial and can be divided into diaphragmatic, hepatic, and colonic causes. Chilaiditi’s sign is considered a cause of pseudo-pneumoperitoneum. On imaging, the sign can easily be misdiagnosed as a ‘true’ pneumoperitoneum, causing the patient to undergo unnecessary investigations and interventions. This case report presents an 88-year-old male with a past medical history of Ischemic Heart Disease (IHD) and Hypertension (HTN) who presented to the Emergency Department (ED) with a clinical picture of obstructive jaundice and was admitted for an Endoscopic Retrograde Cholangiopancreatography (ERCP). Post-ERCP, the patient complained of chest pain, in which a chest X-ray was done, and Chilaiditi’s sign was found.