Posttraumatic hepatic cyst - An unusual sequela of liver injury in the era of imaging

Nonoperative management of blunt liver injury in children has become a generally accepted form of therapy unless vital signs deteriorate or associated injury requires emergency operation. Serial monitoring of the liver with computed tomographic (CT) scans or abdominal ultrasonography contributes much to the management of these children. A persistent intrahepatic hematoma that goes unnoticed for years and eventually results in a cyst with a thick wall that contains viscous yellowish green fluid and sludge occurred occasionally before the era of CT or ultrasound imaging, but it is unusual in modern times. We report on a 7-year-old girl who suffered blunt abdominal trauma that resulted in a grade IV liver injury. Five years later she had a large posttraumatic cyst of the liver that caused abdominal pain. She is now asymptomatic, after decortication of the cyst wall, evacuation of the contents, and filling the residual space with omentum.