A 60-year-old male who had been involved in a motor vehicle collision presented to a local trauma center in a hemodynamically unstable condition with pain in the upper right quadrant area and chest wall. His mental state was slightly drowsy; he exhibited a Glasgow Coma Scale score of 13 (eye opening: 3, verbal response: 5, and motor response: 5), and his vital signs were judged as indicating class II trauma (blood pressure, 100/70 mmHg; pulse rate, 106 beats/min; respiratory rate, 22 breaths/min; body temperature, 36.2°C). The trauma team performed a focused assessment with sonography in trauma examination to identify abdominal fluid, and the findings revealed positive results in Morison’s pouch and the perihepatic area. Contrast-enhanced abdominal CT suggested a liver laceration, with organ injury scale grade III and intraparenchymal subcapsular hematoma in segments 4, 5, and 6 and active bleeding in the gallbladder due to injury (
Fig. 1). Since the patient’s vital signs were unstable, as a part of non-operative treatment, hepatic angioembolization in the A5 culprit area was performed to establish hemorrhagic control (
Fig. 2A). Focal contrast extravasation was observed on cystic arteriography, but it was decided to proceed with close observations without embolization (
Fig. 2B). Forty-five hours (hospital day 3) after admission, repeated CT of the abdomen was performed because the patient complained of peritonitis symptoms, and showed abdominal guarding, rigidity, and rebound tenderness, mainly in the right upper quadrant. Abdominal CT showed an increased amount of hemoperitoneum in the abdominal cavity, perihepatic fluid collection, and hemoperitoneal fluid (
Fig. 3A). In addition, heterogeneous contrast filling in the gallbladder was observed without active bleeding (
Fig. 3B). The patient underwent percutaneous gallbladder drainage using an 8-Fr pigtail catheter (
Fig. 4A). Liver enzyme (AST and ALT) and bilirubin levels gradually decreased and normalized over 2 weeks (
Table 1). After 27 days, the final abdominal CT before catheter removal showed a collapsed gallbladder over the catheter with resolution of perihepatic fluid collection (
Fig. 4B). The patient’s symptoms improved, and he was discharged without any complications.