Fig. 4

Boerhaave’s syndrome related to esophageal rupture. a Chest X-ray shows pneumomediastinum with subcutaneous emphysema. b Naclerio V sign in another patient. In this case, the Naclerio V sign was the only finding that raised the suspicion of an esophageal rupture (not shown) with a focal and limited pneumomediastinum. c Axial CT scan in lung windowing that shows the pneumomediastinum with bilateral pleural effusion and alveolar consolidation (d). Iodine hydro-soluble contrast on a lateral view shows extravasation above the diaphragm in front of the esophagus (Patient (a))