Chest roentgenographic findings in 26 patients with traumatic rupture of the thoracic aorta.

The initial 100-cm anteroposterior (AP) supine chest roentgenograms of 26 patients with proven traumatic aortic rupture were reviewed. The 20 male patients and six female patients ranged in age from 12 to 75 years. Distortion of normal aortic contour or blurring of the aortic outline occurred in 23 cases. Opacification of the radiolucent space between the aorta and pulmonary artery was seen in 22 instances. The mean mediastinal width, measured at the superior border of the anterior fourth rib, was 9.4 cm. Obliteration of the medial aspect of the left upper lung field was observed on 13 films. Obliteration of the shadow of the descending aorta, hemopneumothorax, and tracheal shift to the right each occurred in 17, 14, and 12 cases, respectively. This study illustrates that distortion or blurring of the aortic arch contour, opacification of the clear space between the aorta and pulmonary artery, and increased mediastinal width (mean = 9.4 cm) are the most frequently occurring abnormalities on the initial AP supine chest films of patients with traumatic aortic rupture. Such findings should arouse the suspicion of aortic rupture, and warrant aortography.