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Upright frontal chest radiograph demonstrates air below the right hemidiaphragm (red arrow) and air tracking along the left heart and mediastinal border towards the apex (yellow arrows) consistent with a pneumoperitoneum (red) and pneumomediastinum (yellow).

Note: Images are shown for illustrative purposes. Do not attempt to draw conclusions or make diagnoses by comparing these images to other medical images, particularly your own. Only qualified physicians should interpret images; the radiologist is the physician expert trained in medical imaging.