It is a rather striking paradox that the most dramatic of all vascular accidents is seldom recognized ante mortem. There have been almost 500 cases dealing with rupture of the aorta reported in the literature, and in only nine1 instances has a correct antemortem diagnosis been made. Swaine,1a Mager,2 Davy and Gates,3 Hirschboeck and Boman,4 Moosberger,5 Vaughan,6 Kellogg and Heald,7 White,8 and Weiss9 are listed as having correctly diagnosed cases. Wyss10 is said to have diagnosed a case, but it seems from his statement that a saccular aneurysm was suspected rather than a dissecting aneurysm, as is also true in the cases of Osler11 and Finney.12
We are reporting three cases in which a correct antemortem diagnosis was made, bringing the total number to twelve, which is far short of those in which a diagnosis could have