Torso stab injuries near the cardiac box may present unique challenges due to difficulties in hemorrhage control. For a stab injury to the heart, the repair is straightforwardly performed via median sternotomy. In contrast, injuries to the inferior vena cava are challenging to repair, especially when they are close to the diaphragm, and the bleeding can be torrential. Herein, we describe a case of a self-inflicted stab wound within the "cardiac box." The trajectory of the stab injuries went below the diaphragm and injured the infradiaphragmatic inferior vena cava. Successful emergent repair via the thoraco-laparotomy approach revived the young man. In this report, we revisit and discuss previous large series of patients with this rare vena cava injury.

Hidden cause of intestinal bleeding from jejunal diverticulum revealed on enteroscopy and treated successfully with segmental resection A 73-year-old man presented with haematemesis and melaena for 1 day to the emergency department. He has long-standing diabetes mellitus and hypertension. He had an episode of tachycardia at 120 beats per min and hypotension of 80/50 mmHg requiring fluids and blood transfusions. He was pale and lethargic. His abdomen was soft with no palpable mass. Digital rectal examination revealed melaena and no rectal mass was felt. His haemoglobin level was 6.5 g/dL. Following 2 L of crystalloids and 3 U of packed cell transfusion, an emergency upper gastrointestinal endoscopy was performed that revealed normal gastric and duodenal mucosa with no stigmata of recent bleeding. Colonoscopy was attempted till caecum only because he had recurring episode of hypotension despite the resuscitation. The examined part of the colon revealed dark coloured stools which suspected that the source of bleeding originated from the small bowel.