Background: Major bile leaks from blunt liver injuries are uncommon but difficult. Management generally involves endoscopic retrograde cholangiography (ERCP). This case study aims to verify the importance of ERCP after blunt hepatic trauma. Case presentation: A 20-year-old patient with a history of blunt abdominal trauma presented one month later with abdominal distension, imaging showing hepatic injury with ascites, and the role of early ERCP efficacy in management.Conclusion: High-grade, central liver damage following acute liver trauma. ERCP should be scheduled early if the patient has risk factors and a plasma bilirubin level over 2.5 mg/dL at admission.