ABSTRACT
Two patients (man and woman aged 28 and 82 years respectively) are reported with accidentally diagnosed Chilaiditi's syndrome and sign (abnormality without clinical manifestation). Pathogenesis of both the syndrome and the sign appears complicated and ambiguous. The abnormality was recognized when the patients visited the clinic for planned medical examination. The patient with Chilaiditi's syndrome periodically complained of abdominal discomfort. His physical examination revealed the "lack" of hepatic dullness and the presence of very loud peristaltic sounds heard through a phonendoscope in the hepatic region. The elderly woman presented without abdominal symptoms. Intestinal interposition was associated with the upper position of the diaphragmatic cupola. Chilaiditi's syndrome requires treatment in case of serious clinical manifestations or symptoms of acute abdomen. This abnormality should be considered if invasive intervention being planned may be fraught with a risk of gut injury. The outcome of surgical correction is as a rule fairly good.