Injuries to the ascending aoae. Usually associated with other injuries like solid organ. Diagnosis: X-ray chest: Widened mediastinume Aoography: Gold standard for diagnosis Contrast enhanced CT, Trans-esophageal Echocardiography (TEE) is useful in making diagnosis. Traumatic Aoic Rupture Clinical Features History of high-speed decelerationQ injury Flail chestQ Fractured sternumQ SVC syndromeQ Multiple or 1st or 2nd rib fracturesQ Upper extremity hypeension or pulse deficitsQ Hematoma in the carotid sheathsQ Interscapular bruitsQ Hoarseness with normal larynxQ Radiographic Features Widening of mediastinumdeg (70%)Q Esophageal detion to the rightQ Tracheal detion to rightQ Leftdeg apical cap (65%)Q Downward displacement of left main stem bronchusQ Right paratracheal stripe thickeningQ Detion of NG tube to rightQ Left hemothoraxQ Displaced left paraspinal stripeQ Displaced right paraspinal stripeQ Treatment: Control of systolic BP to less than 100 mm HgQ Endovascular intra-aoic stentingeQ Direct repair or excision and grafting using a Dacron graftQ">