[Incarcerated Chilaiditi disease. A rare indication for surgery].

Surgery was performed on a rare case of incarcerated Chilaiditi's syndrome, a syndrome that has been known for 10 years. The patient was in the state of ileus with volvulus of the stomach and hepatodiaphragmatic interposition of the stomach, transverse colon, and omentum majus. The patient was at high risk--77 years old and in bad condition due to hyperemesis and abdominal pain. Preoperative intensive care was necessary. During the operation the intestinal structures were repositioned, the diaphragmatic hernia was resected, and the muscular parts were sewn tight. The right position of the liver was reconstructed by sewing the ligaments. Colon resection was inevitable because the colon loop could not be separated and because there was lack of intraabdominal space. For indication of preventive and elective surgery, we propose that the diagnostics be enhanced when Chilaiditi's syndrome is found by chance and is still asymptomatic. These techniques may include a complete radiological examination with contrast medium, intestinal endoscopy, and computer tomography of the thoracoabdominal region.