Chest X-ray PA view of the patient on the day of admission shows a “continuous diaphragm sign” characterised by a mediastinal gas outlining the superior surface of the diaphragm and separating it from the heart (black arrowheads) and a “Naclerio’s V sign” in which mediastinal gas outlines the lateral margin of the descending aorta and extends laterally over the left hemidiaphragm (red arrowheads).