Non-Operative Management of Adult Blunt
Hepatic Trauma Algorithm

Annotation for Point M

Biliary complications include biloma, biliary fistula, bile leak, and bile peritonitis. Approximately, one-third of liver-related complications are biliary in nature with an overall incidence of approximately 3%, although higher rates have been reported.28,36,40 Typically, biliary complications present in a delayed fashion in patients with grade 4 injuries.36 A biloma results when bile leaks into the hepatic parenchyma, increasing pressure leads to necrosis, and eventual formation of a biloma.41 Management consists of percutaneous catheter drainage. It is not known whether all asymptomatic bilomas require treatment.