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

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.