Chilaiditi syndrome is a rare condition when pain occurs due to transposition of a loop of large intestine

Colon (anatomy)

The colon is the last part of the digestive system in most vertebrates; it extracts water and salt from solid wastes before they are eliminated from the body, and is the site in which flora-aided fermentation of unabsorbed material occurs. Unlike the small intestine, the colon does not play a...

 (usually transverse colon

Transverse colon

The transverse colon, the longest and most movable part of the colon, passes with a downward convexity from the right hypochondrium region across the abdomen, opposite the confines of the epigastric and umbilical zones, into the left hypochondrium region, where it curves sharply on itself beneath...

) in between the diaphragm and the liver

Liver

The liver is a vital organ present in vertebrates and some other animals. It has a wide range of functions, including detoxification, protein synthesis, and production of biochemicals necessary for digestion...

, visible on plain abdominal X-ray

Abdominal x-ray

An abdominal x-ray is an x-ray of the abdomen. It is sometimes abbreviated to AXR, or KUB .-Diagnostic Tool:...

 or chest X-ray

Chest X-ray

In medicine, a chest radiograph, commonly called a chest X-ray , is a projection radiograph of the chest used to diagnose conditions affecting the chest, its contents, and nearby structures...

.

Normally this causes no symptoms, and this is called Chilaiditi's sign. The sign can be permanently present, or sporadically. This anatomical variant is sometimes mistaken for the more serious condition of having air under the diaphragm (pneumoperitoneum

Pneumoperitoneum

Pneumoperitoneum is air or gas in the abdominal cavity. It is often seen on X-ray, but small amounts are often missed, and CT is nowadays regarded as a criterion standard in the assessment of a pneumoperitoneum. CT can visualize quantities as small as 5 cm³ of air or gas...

) which is usually an indication of bowel perforation.