Approximately 25% of severe injuries to the aorta occur during:

• A. Rollover collisions.
• B. Frontal collisions.
• C. Rear-end collisions.
• D. Lateral collisions.

Answer: (D)

The main idea is how the aorta gets injured in high-energy crashes. A traumatic tear or rupture of the thoracic aorta happens mainly from rapid deceleration, which creates shearing forces at a fixed point of the vessel—near the aortic isthmus just beyond the left subclavian artery. In a side-impact (lateral) collision, the chest is struck from the side while the rest of the body continues moving. This produces abrupt lateral bending, compression against the spine, and differential movement between the chest wall and the aorta, concentrating stress at the tethered part of the aorta and making rupture more likely. Because lateral crashes deliver a distinct, high-shear load, they account for about a quarter of severe aortic injuries, even though frontal crashes are also common sources of deceleration injuries. When evaluating a patient after a high-energy lateral impact, maintain a high index of suspicion for aortic injury, and look for mediastinal signs on imaging and other thoracic trauma indicators.