The second patient involved in the same MVC with the first patient was a male of 40 years old. This patient was using seatbelt and the airbag was working during the accident. He arrived with a stable hemodynamic status, GCS of 15, and decreased air entry to left lateral field of lung. He had seatbelt marks over his left chest and lower abdomen with moderate degloving injury of left lateral abdominal wall. Secondary survey revealed blood at the external urethral meatus, and had incidental right inguinal hernia. FAST was negative, fracture left mid femur, right radius, fibula and talus. Chest X-ray showed herniation of bowel to left hemi-thorax. CT scan demonstrated grade V left diaphragmatic injury with herniation of abdominal content into left hemothorax [Figure 4], bilateral lung contusions, suspicious of extravasated contrast from prostatic urethra. Patient was shifted to the operating room for repair of diaphragm, insertion of left thoracostomy tube and repair of mesenteric tear of ileocecal junction, rectosigmoid junction, and serosal tear of rectum [Figure 5]. He was extubated after 10 days; open reduction internal fixation for left femur was done after 12 days. The patient was doing well and transferred to trauma floor after 14 days.