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

Abstract

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. © 2004, Hepatobiliary Pancreat Dis Int. All rights reserved.