Ladder-rung tears of aorta - An unusual presentation of medico-legal significance

Ladder-rung tears have been described in the literature as multiple superficial parallel intimal tears in the aorta. They are mostly associated with a road traffic accident. The isthmus part of the thoracic aorta is more vulnerable to this injury as it is tethered. This injury is also more common with old age due to weakness of the vascular walls with the advancement of age. Multiple mechanisms have been proposed in the literature based on different principles of biomechanics. We report an autopsy case of road traffic accident with ladder-rung tears in abdominal aorta in young motorcyclist, which is a rare occurrence, along with a review of possible mechanisms of aortic injuries in road traffic accidents.