A61-year-old woman was admitted to the Department of Vasculocardiology,First Affiliated Hospital of Zhengzhou University presented with recurrent respiratory distress for 2 weeks without fever,cough,phlegm,chest pain ...A61-year-old woman was admitted to the Department of Vasculocardiology,First Affiliated Hospital of Zhengzhou University presented with recurrent respiratory distress for 2 weeks without fever,cough,phlegm,chest pain or hemoptysis.Her symptom had generally worsened at night when she lying supine,and that could be partly alleviated when she had a seat or stand for a few minutes.Two weeks ago,the patient was admitted to the local hospital with diagnosis of ＂coronary disease;chronic hepatitis B;stage Ⅱ hypertension＂.After administered with conservative treatment,her symptoms were not significantly alleviated.The patient was then referred to our hospital in September 2012 for further evaluation and treatment.The patient had a past medical history of hypertension with regular medications of compound kendir lenves （one tablet daily） and reserpine （one tablet daily）.Her family history was negative.展开更多
Symptomatic hepato-diaphragmatic interposition of a bowel loop or Chilaiditi's syndrome is a peculiar anatomical condition most often found by chance. Its described symptoms range from intermittent, mild abdominal...Symptomatic hepato-diaphragmatic interposition of a bowel loop or Chilaiditi's syndrome is a peculiar anatomical condition most often found by chance. Its described symptoms range from intermittent, mild abdominal pain and dyspepsia to acute intestinal obstruction. We report a case of hepato-diaphragmatic migration of the hepatic flexure of the colon associated to an unusual, heretofore unreported, angina-like pain exclusively evoked by the left lateral decubitus. To maximize the chance of observing anatomical changes in different postures, computed tomography of the chest and abdomen was performed after air insufflation into the colon. While frank herniation into the chest was excluded, the scan showed that the hepatic flexure-with the interposition of the diaphragm-came in contact with the right side of the heart in the left lateral, but not in the supine, decubitus. This finding was reproduced by echocardiography which also showed virtually unaltered hemodynamics after the change of posture. ECG, left and right ventricular global and regional function as well as cardiac injury markers also remained unchanged during the maneuver, indicating that the pain evoked by the latter was unlikely due to myocardial ischemia. This case suggests that Chilaiditi's syndrome should be included among the possible, although rare,causes of unexplained angina-like symptoms.展开更多
文摘A61-year-old woman was admitted to the Department of Vasculocardiology,First Affiliated Hospital of Zhengzhou University presented with recurrent respiratory distress for 2 weeks without fever,cough,phlegm,chest pain or hemoptysis.Her symptom had generally worsened at night when she lying supine,and that could be partly alleviated when she had a seat or stand for a few minutes.Two weeks ago,the patient was admitted to the local hospital with diagnosis of ＂coronary disease;chronic hepatitis B;stage Ⅱ hypertension＂.After administered with conservative treatment,her symptoms were not significantly alleviated.The patient was then referred to our hospital in September 2012 for further evaluation and treatment.The patient had a past medical history of hypertension with regular medications of compound kendir lenves （one tablet daily） and reserpine （one tablet daily）.Her family history was negative.
文摘Symptomatic hepato-diaphragmatic interposition of a bowel loop or Chilaiditi's syndrome is a peculiar anatomical condition most often found by chance. Its described symptoms range from intermittent, mild abdominal pain and dyspepsia to acute intestinal obstruction. We report a case of hepato-diaphragmatic migration of the hepatic flexure of the colon associated to an unusual, heretofore unreported, angina-like pain exclusively evoked by the left lateral decubitus. To maximize the chance of observing anatomical changes in different postures, computed tomography of the chest and abdomen was performed after air insufflation into the colon. While frank herniation into the chest was excluded, the scan showed that the hepatic flexure-with the interposition of the diaphragm-came in contact with the right side of the heart in the left lateral, but not in the supine, decubitus. This finding was reproduced by echocardiography which also showed virtually unaltered hemodynamics after the change of posture. ECG, left and right ventricular global and regional function as well as cardiac injury markers also remained unchanged during the maneuver, indicating that the pain evoked by the latter was unlikely due to myocardial ischemia. This case suggests that Chilaiditi's syndrome should be included among the possible, although rare,causes of unexplained angina-like symptoms.
