Rapid onset Chilaiditi's sign on top of fulminant hepatic failure.
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.
Chan
See-Ching
SC
Centre for the Study of Liver Disease and Department of Surgery, the University of Hong Kong, Pokfulam, Hong Kong, China.
Liu
Chi-Leung
CL
Lo
Chung-Mau
CM
Fan
Sheung-Tat
ST
D000328:Adult; D003106:Colon / Q000000981:diagnostic imaging; D003964:Diaphragm / Q000000981:diagnostic imaging; D017809:Fatal Outcome; D006801:Humans; D007416:Intestinal Perforation / Q000000981:diagnostic imaging*; D017093:Liver Failure / Q000000981:diagnostic imaging*; D008297:Male; D011859:Radiography; D013369:Subphrenic Abscess / Q000000981:diagnostic imaging*