LAUSR

A 65-year-old man presented with multiple stab injuries to the left upper chest, neck, and arm. He was protecting his airway, had equal bilateral breath sounds, had palpable distal pulses, and was neurologically intact. His initial set of vitals was unremarkable. His physical examination was notable for left chest wall crepitus and a nonexpanding left neck hematoma. Chest x-ray demonstrated a widened mediastinum and small left hemothorax (Fig. 1). His extended focused assessment with sonography in trauma was negative. Because of hemodynamic stability, the patient underwent computed tomography angiography (CTA) of the neck, chest, abdomen, and pelvis to elucidate the course of multiple stab wounds. On initial imaging, he was found to have multiple sternal fractures, mediastinal hemorrhage, left hemothorax, and active extravasation of contrast material from the aortic arch (Fig. 2). He also had extensive subcutaneous emphysema in the neck and retroesophageal air. There was no evidence of intracranial or intra-abdominal injuries.