[Hepatic disorder during long-term intravenous hyperalimentation in adults]

Hepatic disorder during long-term intravenous hyperalimentation (IVH) in adults was studied. Fifty-one patients (30 males and 21 females) in whom IVH was performed for more than 60 days at Tenri Hospital from 1975 to 1984, were divided into 3 groups by change of indices which showed hepatic cellular injury (CII) and bile stasis (BSI). Namely, type I patients (33 cases) showed transient abnormality of indices, type II patients (14 cases) has continuous abnormal indices during IVH and type III patients (4 cases) were lethal due to hepatic failure. There were no differences in clinical feature among 3 groups. Incidence of metabolic complications during IVH in type II was significantly higher than in type I (p less than 0.05). All patients of type III were complicated by severe infectious diseases. Chief histological findings from 13 specimens (6 biopsies and 7 autopsies) were fatty degeneration of hepatocytes and fibrosis in the portal area with proliferation of bile ducts. Change of the portal area had closer relationship to the clinical severity of hepatic disorder than change of hepatocytes. BSI was more important than CII in inspection of clinical course and estimation of prognosis on hepatic disorder during IVH.