Teenager in a motor vehicle accident CXR AP (above left) shows a widened superior mediastinum. Axial CT with contrast of the chest shows an aortic laceration beginning at the level of aortic isthmus (above right) with a large amount of hemorrhage in the mediastinum which continues downward (below left) until the aorta is almost completely occluded by thrombus (below right). The diagnosis was thoracic aortic injury.