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Large left haemothorax and mediastinal haematoma with dilated ascending aorta and false aortic lumen starting at the apex of the arch extending into the left common carotid and base of the left subclavian arteries, and then into the descending thoracic aorta albeit the false lumen is thrombosed distally.  Contrast in the false lumen at the arch is irregular in contour and although there is no contrast leak into the left pleural space, this is likely to be the point of rupture.