# Nonoperative Management of a Major Traumatic Hepatic Injury in a Five-Year-Old Boy

## TL;DR

A five-year-old boy with severe liver trauma was successfully treated without surgery using nonoperative methods and minimally invasive procedures.

## Contribution

This case demonstrates the successful use of minimally invasive techniques to manage a bile leak during nonoperative management of pediatric liver trauma.

## Key findings

- Nonoperative management was effective for a grade V liver injury in a child.
- A bile leak was successfully treated with percutaneous drainage and endoscopic sphincterotomy.
- Minimally invasive interventions can manage complications during nonoperative liver trauma care.

## Abstract

Nonoperative management (NOM) is the standard approach for stable pediatric liver trauma, though rare complications like bile leaks may occur. We present the case of a five-year-old boy with a grade V liver laceration following blunt abdominal trauma. Despite initial hypotension, he was stabilized and managed nonoperatively. On day 5, he developed jaundice and abdominal distension due to a significant bile leak. Imaging confirmed biliary injury, and the leak was successfully managed with percutaneous drainage and endoscopic sphincterotomy with common bile duct stenting. This case highlights the effectiveness of minimally invasive interventions in managing traumatic bile leaks during NOM.