Motor vehicle injury usually is a blunt trauma. Some time it is associated with open injury. Same cases the evaluation and treatment are a challenge to trauma surgeon. Present a case of open thoraco-abdominal injury showing the difficulty of the evaluation and treatment39 year old man - motorcycle accident against car - bleeding left thoracoabdominal wound extended from the anterior axillary line to the spinal column with exposure of the diaphragmI'll show how was the treatment of abdominal injury and how to fix the diaphargm and close the left pleura cavity