Pre-operative planning chest X-ray.
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Gas-filled colonic loops are interpositioned in between the right hemi diaphragm and the liver.
Chilaiditi syndrome is one of the causes of pseudopneumoperitoneum and occurs when bowel gas is interposed between the liver and the hemidiaphragm resulting in pain. Gas in this position may be misinterpreted as true pneumoperitoneum resulting in further imaging, investigation and treatment that is not required.