Rapid onset Chilaiditi's sign on top of fulminant hepatic failure

Hepatobiliary Pancreat Dis Int. 2004 Aug;3(3):476-7.


Fulminant hepatic failure is a medical emergency. When this condition declared itself irreversible, a timely liver transplantation is the only effective treatment. A 34-year-old Chinese with fulminant hepatic failure was evaluated as a potential liver transplantation candidate. On the erect chest radiograph, Chilaiditi's sign has developed over a very short period of a week due to rapid shrinkage of the liver. Awareness of Chilaiditi's sign facilitated distinguishing the condition of free gas under the diaphragm due to bowel perforation and subphrenic abscess by gas forming micro-organisms. Rapidity of onset of this sign parallels the deterioration of liver function and reflects the urgency of condition.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Colon / diagnostic imaging
  • Diaphragm / diagnostic imaging
  • Fatal Outcome
  • Humans
  • Intestinal Perforation / diagnostic imaging*
  • Liver Failure / diagnostic imaging*
  • Male
  • Radiography
  • Subphrenic Abscess / diagnostic imaging*