2007, Number 3
Acta Pediatr Mex 2007; 28 (3)
Jiménez-Urueta PS, Ponce-Rosas A, Sánchez-Michaca VJ, González-Mora E, Castañeda-Ortiz RA
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ABSTRACTIntroduction. Cholelithiasis is an unusual finding in neonates. Gallstones and common bile ducts stones develop in neonates with risk factors for cholestasis such as prematurirty, sepsis, hemolysis, total parenteral nutrition, dehydratation. Hepatobilliary dysfunction occur during parenteral nutrition. Usually reversible in newborns. The pathogenesis of cholestasis is multifactorial. Diagnosis is made with abdominal ultrasonography.
Case report. A 2,940 g boy was born at 35 weeks of gestation. The prenatal history was significant for polihidramnios. The neonate initially receiving total parenteral nutrition. During the first 24 hours of life, he presented with abdominal distention; there were radiographic evidence of ileon atresia. The patient had surgery to correct the ileon atresia with an intestinal anastomosis. Four weeks after surgery jaundice appeared (total bilirrubuin 12.0 mg/dL). Abdominal ultrasonography revealed evidence of cholestasis and cholelithiasis, jaundice was presumen to be result of total parenteral nutrition-induced cholestasis. Intestinal continuity was reestablished to facilite to enteral feeding .cholecystectomy was performed.
Discussion. Cholelithiasis in the premature neonate presents several problems. The patient had complications of prematurity leading. Cholelithiasis, multiple risk factors for calculus formation were present including parenteral nutrition and sepsis.