Affiliation:
1. Division of Pediatric Gastroenterology and Nutrition Edmond and Lily Safra Children's Hospital Tel‐Hashomer Israel
2. Sackler Faculty of Medicine Tel‐Aviv University Tel‐Aviv Israel
3. Neonatology Department (Neonatal Intensive Care Unit) Edmond and Lily Safra Children's Hospital Tel‐Hashomer Israel
Abstract
AbstractUmbilical venous catheters are commonly inserted in critically ill newborns and can lead to severe complications when misplaced. We report a preterm female with a prenatal diagnosis of duodenal atresia who presented 2 days after the surgical repair with abdominal distension, hemodynamic instability, elevated liver enzymes with severe cholestatic jaundice, and a hepatic collection on abdominal sonography. An urgent explorative laparotomy demonstrated a large amount of white, milky‐appearing fluid in the abdominal cavity. Together with the sonographic findings, this led to the diagnosis of hepatic total parenteral nutrition extravasation. Upon removal of the umbilical venous catheter line, the infant's clinical state rapidly improved; however, cholestasis continued for months, with a very slow resolution. During follow‐up, the liver enzymes normalized, and a complete resolution of the liver collection was observed, without drainage.
Subject
General Earth and Planetary Sciences,General Environmental Science