An 8-year-old male presented twenty days after blunt force abdominal trauma, involving a steering wheel impact into the patient's right-upper quadrant after collision of a ride-on-lawnmower into a tree followed by ejection off the vehicle. He reported significant pain initially, which was followed by abdominal and flank bruising. At the time, his parents thought the injury trivial and did not seek medical attention. For the subsequent 3 weeks they noted he was not his normal self, with lethargy and poor oral intake. He missed school because of persistent abdominal pain. They presented to their General Practitioner (GP) and were referred for basic blood tests, which identified a haemoglobin (Hb) of 56g/L. The GP referred them to the nearest Emergency Department, a metropolitan level 2 centre. On presentation, the patient was haemodynamically unstable, with a fever of 38.6° Celsius, tachycardia of 130 beats/minute and tachypnoea of 30 breaths/minute. The patient was examined by the adult general surgical registrar who felt a right-upper quadrant mass and organised an urgent contrast-enhanced CT scan. This demonstrated a liver laceration through the right lobe with a large subcapsular haematoma (139 x101 × 189mm), and an associated 10 × 8mm pseudoaneurysm continuous with a branch of the right hepatic artery, in keeping with an AAST grade 3 liver injury [1] (Fig. 1.). The mass effect of the haematoma was causing almost complete occlusion of the Inferior Vena Cava, displacement of the liver hilum and slight compression of the right kidney (Fig. 2.). Blood tests confirmed a severe normochromic, normocytic anaemia (Hb 57g/L) with thrombocytosis (Platelets 764) and Haematocrit 0.17, INR 1.5 and Prothrombin time 17 seconds. Liver function tests were only mildly deranged; lactate dehydrogenase was elevated at 890U/L; electrolyte deficiencies were noted with Na 129mmol/L, Cl 95mmol/L and Albumin 25g/L.