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Rapid onset Chilaiditi’s sign on top of fulminant hepatic failure |
See-Ching Chan, Chi-Leung Liu, Chung-Mau Lo and Sheung-Tat Fan |
Hong Kong, China
Author Affiliations: Centre for the Study of Liver Disease and Department of Surgery, the University of Hong Kong, Pokfulam, Hong Kong, China (Chan SC, Liu CL, Lo CM and Fan ST)
Corresponding Author: Sheung-Tat Fan, MD, PhD, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China (Tel: 852-2855-4703; Fax: 852-2818-4407; Email: hrmsfst@hkucc.hku.hk) |
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Abstract 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.
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