2026 Volume 46 Issue 5 Pages 602-606
A 52-year-old man visited another hospital with the complaint of abdominal pain and an upper abdominal bruise caused by blunt trauma, but he was discharged home due to the absence of any abnormal findings. As his symptoms persisted, he was admitted to our hospital two days after the injury. Abdominal CT revealed findings suggestive of gastrointestinal perforation, and emergency surgery was performed. During the surgery, a perforation was found in the duodenal bulb, and simple closure and omental coverage of the perforation were performed. On the third postoperative day (fifth day after the injury), the drainage fluid suddenly turned bloody, and a CT revealed liver injury, which led us to make a diagnosis of delayed liver injury. Since there was no active bleeding, we selected conservative treatment. In cases of liver injury involving subcapsular rupture, no symptoms or findings may be observed immediately after the injury. Delayed liver injury may be discovered due to something other than abdominal pain, and the time of symptom onset may vary widely, including long after the injury is sustained. It is important to instruct patients sustaining blunt abdominal trauma to seek medical attention if symptoms such as abdominal pain recur, even if a long time has passed after the trauma is sustained.
