The literature is replete with articles and case reports concerning all types of injury to the aorta. Open trauma, by its very nature, is readily recognized and is often approached positively. The lack of aggressive attack in cases of closed injury to the aorta is probably due to several factors. First, one must be familiar with how the injury occurs,1,5,12where it occurs,5,12,10and how it is manifested.2,14,16Knowing these basic things, one can make the diagnosis. Secondly, one must comprehend the variety of injuries1,3,5,11,12possible and the principles of vascular surgery2which may be brought to bear in the individual case. When one has these facts at hand, a rational plan of therapy may be evolved. Closed injury to the aorta usually results from a combination of forces acting on the dynamic blood column within the thorax. The forces are (1) inertia, or "drag,"