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Association of cholelithiasis with total parenteral nutrition and fasting in a preterm infant
Canadian Medical Association Journal
|July 15, 1984
Insights
Infant cholelithiasis, or gallstones, is rare. This case study shows that discontinuing total parenteral nutrition (TPN) and resuming oral feeding can lead to spontaneous gallstone disappearance in preterm infants.
Area of Science:
- Pediatric Gastroenterology
- Neonatal Medicine
- Medical Imaging
Background:
- Cholelithiasis (gallstones) is infrequently diagnosed in the infant population.
- Prolonged fasting and total parenteral nutrition (TPN) are recognized risk factors for developing gallstones, particularly in preterm neonates.
Observation:
- A case is presented of a preterm infant boy who developed cholelithiasis during a period of prolonged fasting necessitating TPN.
- Diagnosis was confirmed using ultrasonography, revealing the presence of gallstones.
Findings:
- The infant experienced cholestasis concurrently with gallstones.
- Upon cessation of TPN and reintroduction of oral feeding, the gallstones spontaneously resolved without intervention.
Implications:
- This case highlights a potential non-invasive management strategy for infant cholelithiasis associated with TPN.
- It suggests that optimizing nutritional support and minimizing TPN duration may prevent or resolve gallstone formation in vulnerable infants.
Abstract:
Cholelithiasis is uncommon in infants. A case of cholelithiasis in a preterm boy who required total parenteral nutrition (TPN) because of prolonged fasting is described. The diagnosis was confirmed by ultrasonography. Despite cholestasis, reintroduction of oral feeding and discontinuation of TPN resulted in the spontaneous disappearance of the gallstones.