A case of Chilaiditi's syndrome in a patient on long-term peritoneal dialysis

• Published in: Journal of Japanese Society for Dialysis Therapy Vol. 26; no. 7; pp. 1341 - 1344
• Main Authors: Uchida, Hiroyuki, Sakai, Osamu, Tokudome, Goro, Hayakawa, Hiroshi, Kawamoto, Shinya, Sakai, Soichi
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society for Dialysis Therapy 1993
• ISSN: 0911-5889; 1884-6211; 1884-6211
• DOI: 10.4009/jsdt1985.26.1341

Chilaiditi's syndrome is a state of bowel interposition between the diaphragm and the liver. It can happen as aresult of megacolon, diaphragmatic paralysis, liver cirrhosis and certain other factors. However, it is very uncommon in patients undergoing peritoneal dialysis. We report a 69-year-old female who was followed in our urology department for bilateral multiple urinary tractstones and had a nephrostomy in 1971. However renal function steadily deteriorated due to obstructive uropathy. ln 1981, she developed chronic renal failure requiving dialysis therapy. A Tenckoff Catheter was inserted and intermittent peritoneal dialysis (iPD) was initiated. About ten years passed without major difficulties. Then iPD had to be discontinued because of fungal peritonitis So she was switched to hemodialysis. After 6 months, she complained of chest discomfort and an X-ray demonstrated right diaphragm elevation and CT showed interposition of bowel between the right diaphragm and the liver. Chilaiditi's syndrome was diagnosed. In this case, long-term iPD in the supine position could be one cause of Chilaiditi's syndrome.