Failure of percutaneous liver biopsy: anatomical variation

Anatomical variation may result in failure to obtain hepatic tissue at liver biopsy. A patient is reported in whom routine liver biopsy was unsuccessful. Subsequent computed tomography (CT) showed that the right lobe of the liver was partially deficient anteriorly and that the biopsy had caused an intraabdominal haematoma. A technically successful biopsy was subsequently carried out under radiological (CT) guidance. Variations in hepatic anatomy are considered and some conclusions are offered which may both improve the success rate and further reduce the morbidity of routine percutaneous needle biopsy of the liver.