Aurora Toubi, MD

A 6-month-old boy was hospitalized because of fever and suspected central line sepsis. He had been receiving total parenteral nutrition (TPN) since shortly after birth following a small-bowel resection, which was performed to repair a midgut volvulus. Abdominal ultrasonographic findings after the procedure were normal. The infant was born at term after an uneventful pregnancy and delivery. Alkaline phosphatase and γ-glutamyl transpeptidase levels were elevated, without hyperbilirubinemia. An ultrasonogram showed hyperhomogeneous and nonhomogeneous echogenicities of the liver, consistent with fatty changes and fibrosis.