<prompt> In A, injury to aoa causing aoic rupture is most commonly seen in?PedestrianMototcyclistCar driverPerson accompanying car driver  <response>: Traumatic Aoic Rupture Traumatic Aoic Rupture is a cause of sudden death after an automobile collision or fall from a great height Vessel is relatively fixed distal to the ligamentum aeriosum, just distal to the origin of left subclan aery Causes : Trauma to the chest, Rapid deceleration injury Clinical presentation Traumatic Aoic Rupture is lethal in 75-90 of patients and only 15-20 arrive at the hospital alive Approximately 90 of those who arrive alive at the hospital have an injury in the region of the Aoic isthmus Injuries to the ascending aoa. Usually associated with other injuries like solid organ. Diagnosis X-ray chest : Widened mediastinum Aoography : Gold standard for diagnosis Contrast enhanced CT, Transesophageal Echocardiography TEE are useful in making diagnosis Treatment Control of systolic BP to less than 100mmHg Endovascular intra-Aoic stenting Direct repair or excision Grafting using a Dacron graft Ref : CSDT 11th edition Pgno : 257-259 