RADIOLOGY: AORTA: Case# 33721: AORTIC ARCH TRAUMATIC RUPTURE, ACUTE MEDIASTINAL HEMATOMA. 21 year old male status post motor vehicle accident. 1. Acute mediastinal hematoma. 2. Focal bulge and irregularity of the medial aspect of the right aortic arch may represent site of aortic injury and less likely a prominent ductus arteriosus (diverticulum). Aortic angiogram may be performed to further evaluate this abnormality. 3. Bilateral small pleural effusions without pneumothoraces. Lungs demonstrate no focal abnormality.