The diagnosis of flank and back injuries is a challenge. In this region, some viscera are extraperitoneal and the symptoms provoke by these injuries often not be present at initial assessment. Missing or delay diagnosis this injury can result in retroperitonitis or even a peritonitis, worsens the prognosis. The most important thing is to keep in mind the high index of suspicion of these injuries. Clinical observation, tomography and laparoscopy are methods. Presented a case flank gunshot wound initially was assessment at a secondary trauma center and discharge. 24 hours late comes to trauma center with complication of missing injury. I'll show the diagnosis and the treatment. The use of videolaparoscopy in this case. See the diagnosis and the management of colon injury. It washes peritoneal cavity, resect the injured colon and made a colostomy. The patient was discharge at 5th postoperative day. Conclusion: Case shows a tangential left flank injury with descending colon injury, a thermal injury. The most important factor in this case is the suspicion of intra-abdominal injury in patients with tangential flank injuries to avoid complication. Video laparoscopy is a useful diagnostic and therapeutic resource in selected trauma cases.