Abstract:

We read with great interest the presentation of the phenomenon entitled "Chilaiditis syndrome and stomach cancer", prepared by the head and his friends and published in the first edition of 2019 of your magazine (1). We thank the authors for this post that emphasizes the association of Chilaiditi syndrome with malignity. However, we would like to point out a few points that could contribute to the discussion of the fact. Although it was by the Vianese radiologist Demetrius Chilaiditi in 1911 and mentioned by his name, it was by Cantini in 1865 and by Beclere in 1899 the outopsy and X-ray findings of this syndrome in the subdiyarragmatic apse case. However, in literature, asymptomatic patients are referred to as "symptom of chilaiditis" and in symptomatic cases as "chilaiditis syndrome" (2). Demetrius Chilaiditi is one of the pioneers of modern radiology and one of the first members of the Turkish Radiology Association (3). Different anatomical subtypes of the colon's hepatodiaphragmatic interposition are identified. The most commonly seen subtype is the form of the colon in the front of the diaphragm and above the right lob of the liver, in the frontal subfrenic space. The subtype of hepatodiagmatic interposition in the subfrenic sphere is a rare subtype. Combined anterior and posterior colonial interpositions are more rare (4). Three radiological findings characteristic of the Chilaiditis symptom are: the placement of the colon or thin abdominal segments between the diaphragm and the liver (segments are often dilated in symptomatic patients), the elevation of the right hemodiam, the form of the change of the liver to the medial. Conditions where the colonial gas image is located laterally or rearly, and where it is not observed on the liver, are called incomplete hepatodiagmatic interposition (5). Early recognition of Chilaiditis syndrome; this rare state can lead to unnecessary surgical interventions, mixed with pnömoperitoneum, which is considered a surgical emergency, and cause unnecessary surgical interventions. Specifically in X-ray, graphs taken in the left lateral decubitus position that shows the column haust under the right hemodiagram in cases that are monitored by the gas image under the right hemodiagram and difficult to distinguish between pnömoperitoneum and psödo-pnömoperitoneum can help. The computer tomography has been proven to be diagnosed (4,5).

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