Another CT scan performed on the third day of admission for unexplained loss of hemoglobin. The ulcer in the arch is now clearly demonstrated (arrow) and perforating the media. The aortic wall is thickened compared with the previous scan, and a mild enhancement of the media is seen throughout the descending aorta. Additional findings are partial atelectasis in the left lower lung base and pleural fluid.
Also, note the left shoulder fracture and vertebral fractures in the upper thoracic spine.