Abstract
BACKGROUND: Chilaiditi syndrome presenting with platypnea is a rare but clinically interesting condition. Platypnea describes breathlessness that worsens in an upright position and improves when lying down. In cases linked to Chilaiditi syndrome, this is often caused by the displacement of the intestines between the liver and diaphragm, which can compress or distort the thoracic cavity, potentially impacting lung function or circulation. CASE PRESENTATION: A 70-year-old Sudanese male known with hypertensive and Benign prostatic hyperplasia on treatment presented to the emergency department with breathlessness in a sitting position of gradual onset with epigastric palpitations, low-grade fever and suprapubic pain with burning micturition and constipation. He had no chest pain, lower limb swelling, or cough, and oxygen saturation was 91% in a supine position and 88% in a sitting position on room air. After proper investigations and imaging the diagnosis of chilaiditi syndrome with platypnea was made. The patient was managed conservatively and discharged in good condition and with proper counseling. CONCLUSION: Chilaiditi syndrome with platypnea is a rare condition. Most cases need no intervention just conservative management, so early recognition of the case limits the unnecessary intervention.