Transverse colon volvulus and Chilaiditi syndrome: an exceptional association

The incidence of Chilaiditi's sign is about 0.025 per cent and it is more often in males than females.1, 4 When this sign is ac- companied by clinical symptoms such as abdominal pain, nausea, vomiting, constipation, and, less frequently, angina-like chest pain or respiratory distress, it is known as Chilaiditi syndrome.1 It happens more commonly in males, those older than 65 years, pregnant women, pa- tients with obstructive lung disease or chronic consti- pation, and is associated with mental retardation, renal ectopia, schizophrenia, obesity, and agenesis of the right lobe of the liver.4 Colonic volvulus is the third most common cause of large bowel obstruction in western countries after co- lon cancer and diverticular disease. The predisposing factors of transverse colon volvulus are chronic constipation, distal colon obstruction, post- operative adhesions, and medial intestine malrotation; all of these factors determine the elongation and re- dundancy of the colon facilitating volvulation.4 The radiographic findings of transverse colon vol- vulus often are less specific than those of sigmoid colon and cecal volvulus.