Fish oil emulsion for reversal of intestinal failure-associated liver disease in preterm infants: Three case reports and review of literature

Figure 1 Computed tomography images of Case 3. A: Axial view: Portal lymphatic stasis (orange arrow) and hepatosplenomegaly; B: Coronal view: Hepatosplenomegaly with splenic extension to the left iliac fossa (orange arrow).

Figure 2 Changes in bilirubin and total bile acid levels, and the course of lipid emulsions treatment during hospitalization in Cases 1-3. A: Direct bilirubin peaked at 229.2 μmol/L after soybean-based lipid emulsion (SO-ILE) therapy and dropped to 89.9 μmol/L after 29 days of FO-ILE therapy; B: Direct bilirubin peaked at 191.9 μmol/L after lipid emulsion containing soybean oil, medium-chain triglycerides, olive oil, and fish oil (SMOF) therapy and dropped to 19.9 μmol/L after 47 days of FO-ILE therapy; C: Direct bilirubin (DB) increased slightly after SMOF therapy; after switching to FO-ILE, DB rose to a peak of 356 μmol/L before decreasing to 30.7 μmol/L after a total of 63 days of FO-ILE therapy. SMOF: Lipid emulsion containing soybean oil, medium-chain triglycerides, olive oil, and fish oil; FO-ILE: Fish oil lipid emulsion.