Chilaiditi Syndrome - Air Under Diaphragm Not Always a Surgical Emergency

Chilaiditi Syndrome is a rare syndrome which occurs in 0.025% to 0.28% of the population. In this condition, there is symptomatic disposition of the right colon between the liver and the right hemidiaphragm. The symptoms of the patients can range from acute bowel obstruction to being asymptomatic. Diagnosis of Chilaiditi syndrome is very important as it can lead to lifethreatening complications like perforation, volvulus, and bowel obstruction and is best achieved by doing CT-scan. Here, we describe a case of 59-year-old man who presented with abdominal distention and pain in the abdomen. Chilaiditi Syndrome was diagnosed via radiological methods and the patient was sent to the long term acute care facility as he refused to opt for surgery. Thus, it shows that Air under diaphragm is not always a surgical emergency and not recognizing the pathognomic sign may lead to needless intervention. The clinical manifestations, diagnosis, and management of this syndrome have been analyzed