OCCULT ASCENDING AORTIC RUPTURE IN THE PRESENCE OF AN AIR BAG

A patient presented to the emergency department after a high-speed dec elerating-type motor vehicle accident. Due to activation of his air ba g device, the patient was without significant obvious injury. Upon eva luation in the emergency department he was also without any radiograph ic or physical signs of serious injury. In the ensuing 24 hours, sever e chest pain developed, and subsequent aortography demonstrated a tear of his ascending aorta just distal to the root. Although occult injur y to the aorta and great vessels does occur in a small percentage of p atients, it is quite rare. However, with the advent of air bags, in th e absence of associated injuries, signs, and symptoms, a high index of suspicion must be entertained in decelerating-type accidents to diagn ose occult injury to the aorta and great vessels.