Figure 2c. Complete aortic rupture in a 48-year-old woman with blunt thoracic trauma from a skydiving accident. The lesion was successfully repaired at surgery; however, the patient subsequently died due to severe brain injury. (a) Anteroposterior chest radiograph shows a widened upper mediastinum with a faint left apical extrapleural cap (arrows). (b) Axial CT image of the aortic isthmus shows complete transection of the aortic wall (arrowheads) with a periaortic hematoma and hemomediastinum. (c) Sagittal thin-slab MIP image shows a second, more caudal site of aortic transection (arrowhead) and active mediastinal bleeding. Note the common origin of the brachiocephalic trunk and the left common carotid artery. (d, e) Sagittal volume rendered image (d) and oblique shaded surface display image (e) show both sites of aortic transection (arrowheads) and blood extravasation, thereby facilitating surgical or endovascular intervention.