A 48-year-old man came to the emergency department with altered consciousness and hemoperitoneum following a pedestrian traffic accident. He underwent immediate emergency laparotomy, and on the second day, he required craniectomy because of increase of intracranial hemorrhage. A chest radiograph taken 7 days after admission, showed elevation of the right hemi-diaphragm, and follow-up chest CT showed a right-sided rupture of the diaphragm, which was surgically repaired. Rupture of the diaphragm can be easily overlooked and the diagnosis delayed, especially in unstable patients with multiple trauma or altered level of consciousness, as in the case reported here. [ J Trauma Inj 2017; 30: 16-20 ]

Cardiac papillary fibroelastomas are the second most common primary tumor of the heart and they most commonly affect the left cardiac valves. However, occurrence of this tumor on the right side of the heart has been rarely reported, with only a few cases having been documented on the pulmonary valve. We present here a rare case of a papillary fibroelastoma that occurred on the pulmonary valve and this was successfully managed by replacing the pulmonary valve in a patient with congestive heart failure.

Penetrated injury of common carotid artery (CCA) is rare and extremely lethal. Carotid artery injury tends to bleed actively and potentially occlude the trachea. It can cause fatal neurological complications. An accurate diagnosis and adequate treatment are very needed to the successful outcome of the penetrating vascular injury in zone 1, 2, and 3 of the neck. Open surgical treatment is more invasive and complicated than endovascular treatment. We experienced a case with penetrating injury in neck zone 2. Here, we report the case successfully treated with endovascular stent graft technique. [ J Trauma Inj 2016; 29: 172-175 ]