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Surgical and Radiologic Anatomy

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02.09.2022 | Original Article

The volumetric measurement of developing liver atrophy in patients with Chilaiditi's sign

verfasst von: Hatice Kaya, Emrah Karatay, Davut Tuney

Erschienen in: Surgical and Radiologic Anatomy | Ausgabe 9/2022

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Abstract

Purpose

The Chilaiditi's sign is a hepatodiaphragmatic interposition of the colon and is a rare diagnosed condition. This condition may cause a problem in liver transplantation applications which are progressively increasing in number. Although not reported in the literature, we observed that liver atrophy developed in the intestinal interposition region in patients with Chilaiditi's sign in computed tomography (CT) images. This study aimed to determine the amount of liver atrophy caused by the interposed colon, the factors that change the rate of atrophy, and the effects of this situation on the liver parenchyma.

Materials and methods

A total of 30,000 patients who presented to radiology department with any reason between March 2012 and March 2013 and who underwent thoracoabdominal or abdominal CT imaging were retrospectively analyzed. The volumes of the liver right lobe and lateral/medial segments of the left lobe were estimated in cm³ using Volume Viewer application in 75 cases (20 females, 55 males) in which Chilaiditi's sign was observed in CT images.

Results

17–27% of the lobes affected from the colon interposition were seen to develop atrophy. The ratio of right lobe volume to total liver volume was found to be higher in patients with left lobe atrophy (74%) than right lobe atrophy (55%) (p < 0.001). Similarly, the rate of the volume of the left lobe to the total liver volume was found to be higher in cases with right lobe atrophy (45%) compared to left lobe atrophy (26%) (p < 0.001).

Conclusion

Hepatodiaphragmatic interposition of the colon can cause liver atrophy. This condition should especially be considered in the liver transplantation applications. Compensatory hypertrophy may develop in the unaffected liver lobe and CT is very useful for diagnostic imaging.

Alva S, Shetty-Alva N, Longo WE (2008) Image of the month. Chilaiditi sign or syndrome Arch Surg 143:93–94. https://doi.org/10.1001/archsurg.2007.12-aCrossRefPubMed

Barroso Jornet JM, Balaguer A, Escribano J, Pagone F, Domenech J, del Castillo D (2003) Chilaiditi syndrome associated with transverse colon volvulus: first report in a paediatric patient and review of the literature. Eur J Pediatr Surg 13:425–428. https://doi.org/10.1055/s-2003-44737CrossRefPubMed

Bilodeau M, Aubry MC, Houle R, Burnes PN, Ethier C (1999) Evaluation of hepatocyte injury following partial ligation of the left portal vein. J Hepatol 30:29–37. https://doi.org/10.1016/s0168-8278(99)80005-1CrossRefPubMed

Caicedo L, Wasuwanich P, Rivera A, Lopez MS, Karnsakul W (2021) Chilaiditi syndrome in pediatric patients—symptomatic hepatodiaphragmatic interposition of colon: a case report and review of literature. World J Clin Pediatr 10:40–47. https://doi.org/10.5409/wjcp.v10.i3.40CrossRefPubMedPubMedCentral

Chinnappan K, Abhyankar A, Jameel Z (2008) Chilaiditi’s syndrome with cecal volvulus and perforation. Am Surg 74:1220–1222CrossRef

Elnaggar AS, Griesemer AD, Bentley-Hibbert S, Brown RS Jr, Martinez M, Lobritto SJ et al (2018) Liver atrophy and regeneration in noncirrhotic portal vein thrombosis: Effect of surgical shunts. Liver Transpl 24:881–887. https://doi.org/10.1002/lt.25024CrossRefPubMed

Farkas R, Moalem J, Hammond J (2008) Chilaiditi’s sign in a blunt trauma patient: a case report and review of the literature. J Trauma 65:1540–1542. https://doi.org/10.1097/01.ta.0000208194.49228.03CrossRefPubMed

Fisher AA, Davis MW (2003) An elderly man with chest pain, shortness of breath, and constipation. Postgrad Med J 79:180–184. https://doi.org/10.1136/pmj.79.929.180CrossRefPubMedPubMedCentral

Fiumecaldo D, Buck L (2018) Chilaiditi’s syndrome causing high-grade small-bowel obstruction requiring exploratory laparotomy. Mil Med 183:e281–e283. https://doi.org/10.1093/milmed/usx069CrossRefPubMed

10.

Flores N, Ingar C, Sánchez J, Fernández J, Lazarte C, Málaga J et al (2005) The Chilaiditi syndrome and associated volvulus of the transverse colon. Rev Gastroenterol Peru 25:279–284PubMed

11.

Friesen BR, Gibson RN, Speer T, Vincent JM, Stella D, Collier NA (2011) Lobar and segmental liver atrophy associated with hilar cholangiocarcinoma and the impact of hilar biliary anatomical variants: a pictorial essay. Insights Imaging 2:525–531. https://doi.org/10.1007/s13244-011-0100-9CrossRefPubMedPubMedCentral

12.

Glatter RD, April RS, Miskovitz P, Neistadt LD (2007) Severe recurrent abdominal pain: an anatomical variant of Chilaiditi’s syndrome. MedGenMed 9:67PubMedPubMedCentral

13.

Hecht EM, Wang ZJ, Kambadakone A, Griesemer AD, Fowler KJ, Heimbach JK et al (2019) Living donor liver transplantation: preoperative planning and postoperative complications. AJR Am J Roentgenol 213:65–76. https://doi.org/10.2214/AJR.18.21064CrossRefPubMed

14.

Indiran V, Kannan K, Ramachandra Prasad T, Maduraimuthu P (2017) Chilaiditi sign. Abdom Radiol (NY) 42:2188–2189. https://doi.org/10.1007/s00261-017-1104-9CrossRef

15.

Ji F, Zhang S, Jiang A, Deng H, Li Z (2014) Hypogenesis of the right hepatic lobe and associated Chilaiditi sign. ANZ J Surg 84:394. https://doi.org/10.1111/ans.12568CrossRefPubMed

16.

Kaushik S, Fulcher AS, Turner MA (2003) Segmental hepatic atrophy: a sequela of blunt intrahepatic bile duct injury. J Trauma 54:1225–1227. https://doi.org/10.1097/01.TA.0000028047.45160.F9CrossRefPubMed

17.

Kim RD, Kim JS, Watanabe G, Mohuczy D, Behrns KE (2008) Liver regeneration and the atrophy-hypertrophy complex. Semin Intervent Radiol 25:92–103. https://doi.org/10.1055/s-2008-1076679CrossRefPubMedPubMedCentral

18.

Lorigan JG, Charnsangavej C, Carrasco CH, Richli WR, Wallace S (1988) Atrophy with compensatory hypertrophy of the liver in hepatic neoplasms: radiographic findings. AJR Am J Roentgenol 150:1291–1295. https://doi.org/10.2214/ajr.150.6.1291CrossRefPubMed

19.

Majumder S (2013) Education and imaging. Gastrointestinal: hepatodiaphragmatic interposition of small bowel loop: a rare cause of Chilaiditi's syndrome. J Gastroenterol Hepatol. 28:1253. https://doi.org/10.1111/jgh.12299

20.

Nakagawa H, Toda N, Taniguchi M, Ibukuro K, Tagawa K (2006) Prevalence and sonographic detection of Chilaiditi’s sign in cirrhotic patients without ascites. AJR Am J Roentgenol 187:W589–W593. https://doi.org/10.2214/AJR.05.0597CrossRefPubMed

21.

Orangio GR, Fazio VW, Winkelman E, McGonagle BA (1986) The Chilaiditi syndrome and associated volvulus of the transverse colon. An indication for surgical therapy. Dis Colon Rectum 29:653–656. https://doi.org/10.1007/BF02560330CrossRefPubMed

22.

Plorde JJ, Raker EJ (1996) Transverse colon volvulus and associated Chilaiditi’s syndrome: case report and literature review. Am J Gastroenterol 91:2613–2616PubMed

23.

Radin DR, Colletti PM, Ralls PW, Boswell WD Jr, Halls JM (1987) Agenesis of the right lobe of the liver. Radiology 164:639–642. https://doi.org/10.1148/radiology.164.3.3303118CrossRefPubMed

24.

Saber AA, Boros MJ (2005) Chilaiditi’s syndrome: what should every surgeon know? Am Surg 71:261–263. https://doi.org/10.1177/000313480507100318CrossRefPubMed

25.

Schweizer W, Duda P, Tanner S, Balsiger D, Höflin F, Blumgart LH et al (1995) Experimental atrophy/hypertrophy complex (AHC) of the liver: portal vein, but not bile duct obstruction, is the main driving force for the development of AHC in the rat. J Hepatol 23:71–78. https://doi.org/10.1016/0168-8278(95)80313-0CrossRefPubMed

26.

Vernuccio F, Whitney SA, Ravindra K, Marin D (2021) CT and MR imaging evaluation of living liver donors. Abdom Radiol (NY). 46:17–28. https://doi.org/10.1007/s00261-019-02385-6

27.

Vilgrain V, Condat B, Bureau C, Hakimé A, Plessier A, Cazals-Hatem D et al (2006) Atrophy-hypertrophy complex in patients with cavernous transformation of the portal vein: CT evaluation. Radiology 241:149–155. https://doi.org/10.1148/radiol.2411051102CrossRefPubMed

28.

Weng WH, Liu DR, Feng CC, Que RS (2014) Colonic interposition between the liver and left diaphragm—management of Chilaiditi syndrome: a case report and literature review. Oncol Lett 7:1657–1660. https://doi.org/10.3892/ol.2014.1903CrossRefPubMedPubMedCentral

29.

Yavuz A, Batur A, Bulut MD, Bora A, Göya C, Andic C et al (2015) Anterior hepatic grooves accompanied by Chilaiditi sign: a retrospective radiological analysis of a neglected anatomical fact. Surg Radiol Anat 37:483–492. https://doi.org/10.1007/s00276-015-1443-6CrossRefPubMed

30.

Yin AX, Park GH, Garnett GM, Balfour JF (2012) Chilaiditi syndrome precipitated by colonoscopy: a case report and review of the literature. Hawaii J Med Public Health 71:158–162PubMedPubMedCentral

Titel: The volumetric measurement of developing liver atrophy in patients with Chilaiditi's sign
verfasst von: Hatice Kaya
Emrah Karatay
Davut Tuney
Publikationsdatum: 02.09.2022
Verlag: Springer Paris
Erschienen in: Surgical and Radiologic Anatomy / Ausgabe 9/2022
Print ISSN: 0930-1038
Elektronische ISSN: 1279-8517
DOI: https://doi.org/10.1007/s00276-022-03013-7

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The volumetric measurement of developing liver atrophy in patients with Chilaiditi's sign

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Purpose

Materials and methods

Results

Conclusion

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Materials and methods

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