A 17-year-old boy was brought to the emergency department after his motorcycle collided at high speed with a tree. On arrival, he was in hypovolemic shock. The boy was intubated and a left subclavian catheter was immediately placed for fluid therapy. Bilateral chest tubes were placed for pneumohemothoraces. On the 5th hospital day, acute renal failure developed. A hemodialysis catheter was inserted into the right internal jugular vein. A chest radiograph (Fig. 1) and left superior venacavogram (Fig. 2) were obtained and established the diagnosis of persistent left