Article Text

Case report
Improvement of parenteral nutrition-associated cholestasis in an adult using fish oil-based parenteral nutrition
  1. Lisa H Moyes1,
  2. Rizwana Hamid2,
  3. Juliet Clutton1,
  4. Karin A Oien3,
  5. Ruth F McKee1,
  6. Ewan H Forrest4
  1. 1University Department of Surgery, Glasgow Royal Infirmary, Glasgow, UK
  2. 2Department of Gastroenterology, Royal Alexandra Hospital, Glasgow, UK
  3. 3Department of Pathology, Glasgow Royal Infirmary, Glasgow, UK
  4. 4Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK
  1. Correspondence to Lisa H Moyes, University Department of Surgery, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, UK; lhmoyes{at}


Parenteral nutrition-associated cholestasis (PNAC) is a severe complication of parenteral nutrition. Standard feed preparations contain soybean and olive oil that are rich in ω-6 polyunsaturated fats, and which studies suggest can be hepatotoxic. Preparations containing fish oil, rich in ω-3 polyunsaturated fats, may be hepatoprotective and have been used in the critical care setting as immunotherapy. A case demonstrating dramatic improvement in liver function and overall clinical condition in an adult with PNAC and intestinal failure within 8 weeks of changing to a fish oil-based parenteral feed is reported. As far as is known, this is the first report of an adult patient whose parenteral nutrition-associated liver disease resolved after a parenteral nutrition lipid emulsion was changed to the fish oil-containing emulsion, SMOFlipid.

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  • Patient consent Obtained.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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