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Case Reports

Chilaiditi's Sign Mimicking a Traumatic Diaphragmatic Hernia

^a Department of General Thoracic Surgery, Maebashi Red Cross Hospital, Maebashi, Gunma, Japan
^b Division of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan

Accepted for publication July 9, 2008.

^_* Address correspondence to Dr Kamiyoshihara, Department of General Thoracic Surgery, Maebashi Red Cross Hospital, 3-21-36 Asahi-Cho, Maebashi, Gunma, 371-0014, Japan (Email: micha2005jp{at}yahoo.co.jp).

A 75-year-old man had bruising develop after a traffic accident. A chest roentgenogram revealed elevation of the right hemidiaphragm. A subsequent computed tomographic scan showed interposition of the colon between the liver and diaphragm in front of the liver. Initially, we suspected a traumatic diaphragmatic hernia. Urgent exploratory video-assisted thoracoscopic surgery showed no injury of the right diaphragm. With the benefit of hindsight, there was no rupture of the diaphragm on the image. Hepato-diaphragmatic interposition of the colon is a very rare anomaly. This case was "Chilaiditi's sign" mimicking a traumatic diaphragmatic hernia.