Ileal atresia and multiple jejunal perforations in a premature neonate with gestational alloimmune liver disease

• Main Author: Ryan M. McAdams, MD
• Format: Article
• Language: English
• Published: Elsevier 2017-04-01
• Series: Journal of Pediatric Surgery Case Reports
• Online Access: http://www.sciencedirect.com/science/article/pii/S2213576616302585

Recovery after surgical repair of an ileal atresia with or without intestinal perforation requires prolonged exposure to parenteral nutrition (PN) that may lead to PN-associated liver disease. Early liver failure and cholestasis out of proportion for PN exposure may be a harbinger for gestational alloimmune liver disease (GALD), a potentially life-threatening condition that often requires liver transplant if not treated in a timely manner. This case report presents a premature neonate with ileal atresia and multiple jejunal perforations who developed liver failure and was later determined to have GALD. Recognition of clinical and laboratory findings consistent with GALD is essential to promote early treatment, which can enhance neonatal outcomes and impact future pregnancies.