Naclerio V sign

Last revised by Dr Daniel J Bell on 10 Dec 2021

The Naclerio V sign is a sign described on the plain film in patients with a pneumomediastinum occurring often secondary to an esophageal rupture

It is seen as a V-shaped air collection. One limb of the V is produced by mediastinal gas outlining the left lower lateral mediastinal border. The other limb is produced by gas between the parietal pleura and medial left hemidiaphragm. 

Although Naclerio V sign was originally described in patients with esophageal
rupture, it is not entirely specific to that condition.  

History and etymology

It is named after Emil A Naclerio (1915-1985), an American thoracic surgeon, who first described it in 1957 1,4.

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Cases and figures

  • Case 1: tension pneumomediastinum
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