This case is typical example of Chilaiditi syndrome where a loop of colon is seen lying in the right subdiaphragmatic location between the liver and diaphragm, and is differentiated from Chialiditi sign as the colonic position is thought to cause symptoms.

This diagnosis is important to make as it can mimic a pneumoperitoneum. If not recognized correctly may lead to unnecessary investigations and complications in patients where liver interventions are required.