Rapid Communication| Volume 46, ISSUE 3, e33-e35, March 2011

Minimally invasive colopexy for pediatric Chilaiditi syndrome


      Chilaiditi syndrome is a rare disorder characterized by abdominal pain, respiratory distress, constipation, and vomiting in association with Chilaiditi's sign. Chilaiditi's sign is the finding on plain roentgenogram of colonic interposition between the liver and diaphragm and is usually asymptomatic. Surgery is typically reserved for cases of catastrophic colonic volvulus or perforation because of the syndrome. We present a case of a 6-year-old boy who presented with Chilaiditi syndrome and resulting failure to thrive because of severe abdominal pain and vomiting, which did not improve with laxatives and dietary changes. He underwent a laparoscopic gastrostomy tube placement and laparoscopic colopexy of the transverse colon to the falciform ligament and anterior abdominal wall. Postoperatively, his symptoms resolved completely, as did his failure to thrive. His gastrostomy tube was removed 3 months after surgery and never required use. This is the first case of Chilaiditi syndrome in the pediatric literature we are aware of that was treated with an elective, minimally invasive colopexy. In cases of severe Chilaiditi syndrome refractory to medical treatment, a minimally invasive colopexy should be considered as a possible treatment option and potentially offered before development of life-threatening complications such as volvulus or perforation.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Pediatric Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Chilaiditi D.
        Zur Frage der Hepatoptose und Ptose im allgemeinen im Anschluss an drei Fälle von temporärer, partieller Leberverlagerung.
        Fortschr Geb Röntgenstr. 1910; 16: 173-208
        • Risaliti A.
        • De Anna D.
        • Terrosu G.
        • et al.
        Chilaiditi's syndrome as a surgical and nonsurgical problem.
        Surg Gynecol Obstet. 1992; 176: 55-58
        • Altomare D.F.
        • Rinaldi M.
        • Petrolino M.
        • et al.
        Chilaiditi's syndrome. Successful surgical correction by colopexy.
        Tech Coloproctol. 2001; 5: 173-175
        • Holcomb G.W.
        • Georgeson K.E.
        • Rothenberg S.S.
        Laparoscopic gastrostomy: atlas of pediatric laparoscopy and thoracoscopy. Elsevier, Philadelphia (PA)2008: 33-37
        • Lohr C.E.
        • Nuss M.A.
        • McFadden D.Q.
        • et al.
        Laparoscopic management of Chilaiditi's syndrome.
        Surg Endosc. 2004; 18: 348
        • Saber A.A.
        • Boros M.J.
        Chilaiditi's syndrome: what should every surgeon know?.
        Am Surg. 2005; 71: 261-263
        • Glatter R.D.
        • April R.S.
        • Miskovitz P.
        • et al.
        Severe recurrent abdominal pain: an anatomical variant of chilaiditi's syndrome.
        Med Gen Med. 2007; 9: 67