A-77-old man was admitted to our hospital because of melena in August 2010. Colonoscopy was performed on him, and the case was diagnosed as ulcerative colitis. His symptoms did not abate despite the administration of mesaladine and steroid. He was thus diagnosed with reflactory ulcerative colitis, and underwent total proctocolectomy. The patient had an uneventaful postoperative course and was discharged from our hospital on the 31^st postoperative day. Total proctocolectomy was considerd one of the useful operative procedures for old patients with ulcerative colitis.

Diagnosis of cardiac rupture caused by blunt trauma is sometimes difficult when multi-organ injuries are associated with profound shock. Only prompt diagnosis and urgent treatment can save the patients. We have encountered 16 cases of blunt cardiac rupture, including 4 that survived in the past 10 years. All cases of cardiopulmonary arrest on arrival were unable to be resuscitated. Also, all cases of profound hemorrhagic shock caused by multi-organ injury succumbed. Among the cases in which the region of cardiac rupture was identified, only cases of injury to the right heart chambers were saved. No case of rupture in the left heart chambers survived. It is definitely important to suspect cardiac injury and make a prompt diagnosis to save patients with blunt chest trauma. Ultrasonic cardiography is highly effective for urgent diagnosis of cardiac rupture because it can be performed readily, noninvasively and, therefore, repeatedly.