2026 Volume 46 Issue 3 Pages 442-445
Traumatic injury to the caudate lobe (Spiegel lobe) of the liver is rare. Due to its deep anatomical location and proximity to the retroperitoneal space, no strategies have been established yet because the condition is rare. We report a pediatric case of injury of the caudate lobe of the liver classified as Grade Ⅲ according to the Liver Injury Scale of the American Association for the Surgery of Trauma (AAST) , which was successfully managed by non-operative management (NOM) strategies. A 13-year-old boy was brought to the emergency department two days after he sustained injury by blunt trauma to his back. He complained of abdominal pain and vomiting, and examination of his vital signs revealed a shock state (SBP 70 mmHg, HR 120 bpm). Contrast-enhanced abdominal CT revealed a caudate lobe laceration with intra-abdominal hemorrhage, but no active bleeding at the time. His vitals stabilized with fluid resuscitation, and we selected NOM without surgical or interventional radiology (IVR) procedures. A follow-up CT on hospital day 2 showed the hematoma confined to the lesser omentum. The patient’s symptoms improved rapidly, and he was discharged on hospital day 8. In pediatric patients with hepatic caudate lobe injury (AAST-LIS grade Ⅲ) in whom hemodynamic stability is restored after fluid resuscitation and contrast-enhanced abdominal CT reveals no active contrast extravasation, NOM may be a viable treatment option, provided that close monitoring and immediate access to IVR or operative intervention are available.
