FIGURE 4  Severe liver disease associated with total parenteral nutrition.

From the following article:

Treatment of intestinal failure: home parenteral nutrition

Daniel K Mullady and Stephen JD O'Keefe

Nature Clinical Practice Gastroenterology & Hepatology (2006) 3, 492-504
doi:10.1038/ncpgasthep0580

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Figure 4.  Severe liver disease associated with total parenteral nutrition.

(A) Severe cholestasis with bridging fibrosis in a 38-year-old man receiving long-standing total parenteral nutrition. There is a marked hepatocellular and cannicular cholestasis with pericellular fibrosis. The portal tracts show prominent bile-ductular proliferation and fibrosis, with sparse lymphocytic inflammation. Stained with hematoxylin and eosin, 40times magnification. (B) Evolving cirrhosis in a 41-year-old man receiving long-standing total parenteral nutrition. This section shows established cirrhosis composed of nodules of regenerative hepatocytes surrounded by a dense fibrous band. The hepatocytes show mild steatosis with scattered sinusoidal neutrophils. Mild, mixed infiltration is noted in the portal fibrous tissue, and is associated with focal bile-ductular proliferation. Stained with hematoxylin and eosin, 40times magnification.

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