Development of hepatic cholestasis and fibrosis in patients with massive loss of intestine supported by prolonged parenteral nutrition

A Clinical–Morphological Study on Cholestatic Presentation of Nonalcoholic Fatty Liver Disease

“…Bile duct lesions with a cholestatic presentation are a nonspecific feature of NASH, as other conditions of steatosis may histologically mimic it: (a) alcoholic hepatitis of varying clinical degrees (5)(6)(7)(8)19); (b) several drug-induced injuries (20,21); (c) jejuno-ileal bypass with related "shortcircuiting" of the bowel with or without total parenteral nutrition (22)(23)(24)(25)(26)(27)(28)(29); and (d) hepatitis C (11)(12)(13). Cholestasis may be present at all stages of alcoholic liver disease (5)(6)(7)(8) where microscopic cholangitis (polymorphonuclear inflammation) and intrahepatic cholestasis are the features detected at liver biopsy (8).…”

Total parenteral nutrition therapy and liver injury: a histopathologic study with clinical correlation

“…Much of the literature on TPN has addressed the injury seen in infants with less attention to adults. In infants, the primary findings are described as cholestasis, sometimes accompanied by hepatocellular injury, ductular reaction, fibrosis, and, www.elsevier.com/locate/humpath occasionally, cirrhosis [8][9][10][11][12]. Rare cases of hepatocellular carcinoma have also been reported with prolonged TPN use [13,14].…”

Parenteral Nutrition-Associated Liver Disease in Pediatric Patients: Strategies for Treatment and Prevention

“…PNALD including cholestasis, hepatic fi brosis, and liver failure are the leading causes of death in patients with SBS [ 36 ]. Predisposing factors to PNALD in SBS patients include prolonged duration of PN, reduced intestinal length and loss of epithelial barrier integrity, intestinal bacterial overgrowth, and abnormal bile acid excretion in patients with ileal resection [ 23 ].…”