Damage Control Surgery and perihepatic packing for severe liver and spleen injury, with gallbladder avulsion. Grade IV liver Injury and Grade II spleen injury. DCS with perihepatic packing, gallbladder avulsion and splenectomy. Depacking 48 hours later with biliary drainage and control with clips and sutures of biliary leak from a lacerated biliary duct.Operator Dr. Salomone Di Saverio MD FACS, FRCSAssisting Resident Surgeons: Dr. Alberto Casati and Dr. Edoardo Segalini