We present the case of a 62-year-old male patient who was admitted to the emergency department following a motor vehicle collision, presenting with severe hemodynamic instability due to hemorrhagic hypovolemic shock. Initial clinical and tomographic evaluation identified a massive hemopneumothorax and splenic injury, while the traumatic diaphragmatic hernia and pancreatic laceration were confirmed through emergency surgical exploration. An exploratory laparotomy, splenectomy, and diaphragmatic repair were performed under a massive transfusion protocol. The patient showed a favorable clinical evolution during his stay in the intensive care unit, achieving hemodynamic stability, mechanical ventilation weaning and discharge to the general surgery ward 48 hours after the surgical intervention.