Percutaneous radiological gastrostomy (PRG) is a safe and accepted method of providing enteral nutrition in those with inadequate oral intake. We report a case of PRG that required laparotomy for intrahepatic displacement of a catheter that had been placed inadvertently through the liver under fluoroscopic guidance. Additional ultrasound or CT guidance may help to define a safe tract to avoid liver or colonic injury. Although transhepatic placement is reported to be well tolerated, this case raises concerns of additional morbidity associated with intrahepatic displacement.