Gastric Injury in Percutaneous Transhepatic Liver Biopsy After Living Donor Liver Transplantation: A Report of Two Cases

Percutaneous transhepatic liver biopsy (PTLB) is essential for assessing liver function but carries risks such as bleeding, cholangitis, bowel injuries, and rare fatal complications. Gastric injury following PTLB is rare and not widely reported. This report describes two cases of gastric injury during ultrasound (US)-guided PTLB in patients following living donor liver transplantation. Gastric injury is uncommon, particularly when sampling from the left lobe due to its proximity to the stomach. Ensuring a clear field of vision, meticulous equipment preparation, and skilled technique are crucial for safe PTLB. When there is a risk of gastric injury, using smaller and shorter needles or alternative methods to US-guided PTLB is essential. Gastric injury should be promptly considered and treated if multiple punctures are required and if abdominal symptoms or gastrointestinal bleeding occur after PTLB.