The authors report surgical treatment of a patient with a penetrating abdominal trauma followed by damage to inferior vena cava, liver, duodenum and pancreas, massive bleeding and large retroperitoneal hematoma. Suturing of inferior vena cava defect, liver and pancreas, Billroth II gastric resection, drainage of retroperitoneal space and abdominal cavity were carried out. Postoperative period was complicated by pneumonia and seroma in lesser sac that required percutaneous puncture. Antibiotic therapy was used postoperatively. The patient was discharged in 25 days after surgery.