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BMC Pediatrics

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Open Access 01-12-2019 | Nutrition | Case report

A case report of a challenging diagnosis of biliary atresia in a patient receiving total parenteral nutrition

Authors: Atu Agawu, Andrew Wehrman, Jennifer Pogoriler, Natalie A. Terry, Henry C. Lin

Published in: BMC Pediatrics | Issue 1/2019

Abstract

Background

Total parenteral nutrition (TPN) and biliary atresia (BA) are common causes of cholestasis in infancy. The diagnosis of BA is time sensitive due to an inverse correlation between age at intervention (hepatic portoenterostomy - HPE) and survival without liver transplantation. Clinical, laboratory, and histologic features of BA and parenteral nutrition associated cholestasis (PNAC) are similar, creating a diagnostic dilemma for cholestatic infants on parenteral nutrition. There is limited published information about the natural history of PNAC including time to resolution, or diagnostic tests that distinguish BA from other etiologies of cholestasis.

Case presentation

We present a case of a child diagnosed with BA whose cholestasis began while receiving TPN. His clinical course was notable for transient resolution of his cholestasis after stopping parenteral nutrition and ultimate intraoperative diagnosis.

Conclusions

Clinicians who care for patients who frequently receive TPN should be aware that clinical, laboratory, imaging, and biopsy findings can be similar between BA and PNAC.

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Title: A case report of a challenging diagnosis of biliary atresia in a patient receiving total parenteral nutrition
Authors: Atu Agawu
Andrew Wehrman
Jennifer Pogoriler
Natalie A. Terry
Henry C. Lin
Publication date: 01-12-2019
Publisher: BioMed Central
Keyword: Nutrition
Published in: BMC Pediatrics / Issue 1/2019
Electronic ISSN: 1471-2431
DOI: https://doi.org/10.1186/s12887-019-1446-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

A case report of a challenging diagnosis of biliary atresia in a patient receiving total parenteral nutrition

Abstract

Background

Case presentation

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Case presentation

Conclusions

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