Introduction Chilaiditi syndrome is a rare congenital anomaly. Less reported, especially in pediatric patients. It is anatomically defined as the interposition of the intestinal segments to the hepatodiaphragmatic region. Observation We present a rare case of 10-year-old boy who presented to our emergency department complaining of chest and abdominal pain after trauma, a digestive perforation was suggest initially , but the CT scan retained the diagnosis of chiladiti syndrome. The patient was conservatively managed, the pain was resorved and the clinical and biological evolution was very favorable. Conclusion Pneumoperitoneum poses an important diagnostic sign determining the urgency of management of patients, should be differentied to Chilaiditi sign characterized by specific radiological findings , to provide unnecessary surgical management. Keys words syndrom, Chiladiti, pneumoperitoneum.