Total parenteral nutrition-induced cholestasis mimicking large bile duct obstruction

The authors present a case of cholestatic jaundice which developed during total parenteral nutrition. The histology of the liver mimicked the picture of large bile duct obstruction. However, there was no duct obstruction and the symptoms regressed after the caloric input was reduced. At postmortem examination, the portal inflammatory infiltrate had cleared and was replaced by fibrosis. Alterations in bile chemistry could be responsible for the similarity between the lesions induced by parenteral feeding and those classically described in large bile duct obstruction.