Gallbladder distention in premature neonates receiving parenteral nutrition

Contraction of the gallbladder is mediated through the release of cholecystokinin from duodenal cells secondary to enteral feedings. Premature infants are often nourished by parenteral hyperalimentation leading to prolonged inactivation of the gallbladder. Such inactivation probably accounts for the increased incidence of gallbladder distention observed in premature neonates. Two cases of premature infants are described in whom distention of the gallbladder occurred during parenteral hyperalimentation. The distention resolved spontaneously secondary to the introduction of enteral feedings. A trial period of oral or tube feeding is recommended in such cases prior to any attempt to release the distention by a surgical intervention.