title: Increased incidence of cholestasis during total parenteral nutrition in children--factors affecting stone formation.
abstract: Cholelithiasis is extremely unusual in infants and children. Recently, some cases of cholelithiasis associated with total parenteral nutrition (TPN) have been reported. A group of 400 children receiving TPN were evaluated prospectively for the presence of gallstones and sludge in this report. Eight children (2%) were determined by ultrasonography to have developed cholelithiasis. All of these patients had received large amounts of amino acids (> or = 1.8g/kg/day) and relatively low amounts of fat (< or = 1.7g/kg/day) with a high ratio of non-protein: kcal/ml (> 0.8). It was concluded that the administration of large amounts of amino acids and a high ratio of non-protein: kcal/ml enhanced the risk for formation of gallstones and sludge. Conversely, these are prevented by the administration of appropriate amounts of fat.
authors.affiliation: Department of Pediatric Surgery, Kurume University School of Medicine, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Komura
authors.forename: H
authors.initials: H
authors.lastname: Yano
authors.forename: Y
authors.initials: Y
authors.lastname: Tanaka
authors.forename: T
authors.initials: T
authors.lastname: Tsuru
mesh_terms: D000293:Adolescent; D000596:Amino Acids / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D002779:Cholestasis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008055:Lipids / Q000008:administration & dosage; D008297:Male; D010289:Parenteral Nutrition, Total / Q000009:adverse effects*; D011446:Prospective Studies; D014463:Ultrasonography
chemical_list: D000596:Amino Acids; D008055:Lipids