Right upper quadrant pain.
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Lungs and pleural space are clear, no features to suggest infection. Cardiomediastinal contours are unremarkable and stable compared to the previous imaging. No pneumothorax or subphrenic free gas. Mild gaseous distension of the colon hepatic flexure, which is interposed between the liver and undersurface of the diaphragm.
Chilaiditi syndrome is the anterior interposition of the colon to the liver reaching the under-surface of the right hemidiaphragm with associated upper abdominal pain. This is a clinical diagnosis based on imaging appearances and lack of other causes to explain the pain.