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

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

Research output: Contribution to journalArticle

1 Citation (Scopus)

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.

Original languageEnglish (US)
Article number72
JournalBMC Pediatrics
Volume19
Issue number1
DOIs
StatePublished - Mar 8 2019
Externally publishedYes

Fingerprint

Biliary Atresia
Total Parenteral Nutrition
Cholestasis
Parenteral Nutrition
Hepatic Portoenterostomy
Natural History
Routine Diagnostic Tests
Liver Transplantation
Patient Care
Biopsy
Survival

Keywords

  • Biliary atresia
  • Case report
  • Cholestasis
  • Liver biopsy
  • Total parenteral nutrition

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

A case report of a challenging diagnosis of biliary atresia in a patient receiving total parenteral nutrition. / Agawu, Atu; Wehrman, Andrew; Pogoriler, Jennifer; Terry, Natalie A.; Lin, Henry.

In: BMC Pediatrics, Vol. 19, No. 1, 72, 08.03.2019.

Research output: Contribution to journalArticle

Agawu, Atu ; Wehrman, Andrew ; Pogoriler, Jennifer ; Terry, Natalie A. ; Lin, Henry. / A case report of a challenging diagnosis of biliary atresia in a patient receiving total parenteral nutrition. In: BMC Pediatrics. 2019 ; Vol. 19, No. 1.
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