Splenic flexure volvulus in association with Chilaiditi syndrome: report of a case.

Hepatodiaphragmatic interposition of the intestine, or Chilaiditi syndrome, is uncommon and typically asymptomatic, but it can be associated with symptoms ranging from intermittent, mild abdominal pain to acute intestinal obstruction. Factors such as the interruption or absence of peritoneal attachments and redundant colon with a long mesentery predispose to both Chilaiditi syndrome and colonic volvulus. The presence of hepatodiaphragmatic interposition of the intestine requires no specific treatment in the absence of symptoms. Colonic volvulus in association with Chilaiditi syndrome is treated based on the location of the volvulus. Volvulus of the splenic flexure is typically treated with resection and primary anastomosis. We report only the third case of colonic volvulus in association with Chilaiditi syndrome and the first with volvulus of the splenic flexure.