In blunt thoracic trauma from rapid deceleration, the most common site of traumatic aortic rupture is:

• A Ascending aorta just above the aortic valve
• B Aortic isthmus, just distal to the origin of the left subclavian artery ✓
• C Aortic arch between the origins of the brachiocephalic and left common carotid arteries
• D Descending thoracic aorta at the diaphragmatic hiatus

Explanation

About 90 percent of blunt traumatic aortic ruptures occur at the aortic isthmus, just distal to the left subclavian artery. At this point the relatively mobile arch meets the tethered descending aorta fixed to the spine, so deceleration forces concentrate shear stress there. The ascending aorta is the second most common site but accounts for a much smaller proportion and is usually fatal at scene. The arch between great vessels and the diaphragmatic hiatus are rare locations.

Reference: Sabiston Textbook of Surgery, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.