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Intrahepatic cholestasis with parental alimentation
American Journal of Surgery
|February 1, 1976
Summary
Parenteral alimentation in infants can cause intrahepatic cholestasis, a liver condition. Discontinuing this treatment can reverse liver abnormalities, with no chronic dysfunction observed in survivors.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Neonatal Intensive Care
Background:
- Parenteral alimentation (PA) is critical for critically ill infants lacking gastrointestinal function.
- Intrahepatic cholestasis is a potential complication of PA, particularly in prolonged use.
- Histologic changes in the liver are a key indicator of PA-associated complications.
Purpose of the Study:
- To examine the clinical and histologic evidence of intrahepatic cholestasis in infants receiving PA.
- To assess the reversibility of liver abnormalities after PA discontinuation.
- To determine the long-term hepatic function in surviving infants.
Main Methods:
- Review of clinical records and liver biopsies from eleven infants who received PA.
- Histologic examination for evidence of cholestasis, fibrosis, and hepatocyte membrane changes.
- Monitoring of liver function tests and correlation with PA treatment duration.
Main Results:
- All eleven infants showed histologic evidence of intrahepatic cholestasis.
- Marked cholestasis, fibrosis, and thickened hepatocyte limiting membranes were observed.
- Discontinuation of PA led to normalization of liver histology and function tests.
- Two surviving infants showed no chronic liver dysfunction after 2.5 years follow-up.
Conclusions:
- Intrahepatic cholestasis is a significant risk in infants receiving PA.
- Early detection and discontinuation of PA are crucial for reversing liver damage.
- Long-term hepatic function appears preserved in survivors after PA cessation.