A 58 year-old man was brought to the emergency department after a work-related injury. A whole body CT scan was made, revealing several traumatic lesions and, among them, a IV-V grade liver injury with a shattered right lobe. He was then admitted to the Intensive Care Unit and underwent an angioembolization of the left hepatic artery. On day 7, the patient was found with altered mental status and fever. Lab workup reported leukocytosis, increased total bilirubin and high C-reactive protein. Abdominal ultrasound raised suspicion of gallbladder perforation. Urgent diagnostic exploratory laparoscopy was done. A gangrenous gallbladder was removed and a drainage was placed. On day 12, the patient developed an abdominal compartment syndrome, and was subjected to a left hemicolectomy because of ischemic necrosis. Terminal colostomy and placement of negative pressure wound therapy were performed. On day 14, during wound management, multiple areas of parenchimal ischemia on the left liver lobe were found and biopsed. In addition, a wedge resection of a 5 cm² necrotic area in the III segment was made. On day 17, after the onset of a multi-organ failure (MOF), the patient was again taken to the operating room and underwent right hemicolectomy and left hepatic lobectomy for major hepatic necrosis. Twenty-four hours later, because of the progression of MOF despite aggressive active treatment, it was decided to withdraw from further treatment. After a few hours, the patient went into cardiac arrest and death was recorded.