Chilaiditi syndrome is the association of a radiological and clinical semiology of the interposition of a bowel (usually the transverse colon) between the liver and the diaphragm. We report a case of a 59 year-old woman with medical history of recurrent vena thrombosis and ovarian mass, who presented with epigastric crampy pain, nausea, vomiting and diarrhea. On examination there was tenderness in the right upper quadrant. Chest X-ray showed the presence of air below the right side of the diaphragm. Abdominal computed tomography confirmed the hepatodiaphragmatic interposition of the colon consistent with Chilaiditi syndrome. In the absence of loco regional complication, treatment was conservative. Chilaiditi syndrome is a rare condition which can be due to anatomical variation or to a predisposing condition such as intra- abdominal mass. This misdiagnosed entity can be confused with surgical emergencies.