Non-Operative Management of Adult Blunt
Hepatic Trauma Algorithm

Annotation for Point N

Bile peritonitis, defined as peritoneal and systemic signs of inflammation, typically presents several days after injury. Patients develop systemic inflammatory response syndrome in response to devitalized liver tissue rather than sepsis.⁴² Although laparotomy remains an option, drainage can be safely and effectively performed by laparoscopy.^28,43–45 Although these signs may prompt consideration of a missed bowel injury, the incidence is very low even in patients with high grade injuries.³⁶