PEDIATRICS Vol. 76 No. 6 December 1985, pp. 905-908
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Total Parenteral Nutrition Cholestasis: A Cause of Mechanical Biliary Obstruction

Robert W. Enzenauer MC, USA1, Jill S. Montrey MC, USA1, Peter J. Barcia MC, USA1, and Joseph Woods MC, USA1

1 From the Departments of Pediatrics, Surgery, and Pathology, Tripler Army Medical Center, Honolulu

In a newborn baby with Hirshsprung's disease obstructive jaundice developed following prolonged parenteral nutrition. At laparotomy, thick inspissated bile was flushed from the biliary tree and prompt resolution of the jaundice followed. To our knowledge, this is the first reported case in which inspissated bile appeared to be a complication of total parenteral nutrition. Mechanical obstruction must be recognized as an extreme in the spectrum of total parenteral nutrition cholestasis.

Key Words: total parenteral nutrition cholestasis • inspissated bile syndrome • bile sludge syndrome

Submitted on November 13, 1984
Accepted on March 28, 1985