Jaundice and infantile diarrhoea.

Although it is recognized that infantile diarrhoea may sometimes be complicated by jaundice, the pathogenesis of this jaundice has not been fully eltucidated. The only detailed account of the hepatic lesions in infantile diarrhoea is that of Wainwright (1950), who described in 11 of his 16 cases a form of 'hepatitis' characterized by periportal parenchymal necrosis, infiltration by polymorphonuclear leucocytes and mononuclear cells, proliferation of small bile ducts, inconstant fibrosis, periportal fatty change, distension of bile canaliculi in the centres of the lobules and congestion accompanied by varying degrees of centrilobular necrosis. In his remaining four cases there was centrilobular bile retention only. Wainwright noted a resemblance to experimental allyl formate poisoning and considered the hepatitis to be due to toxic parenchymal damage. Holland and O'Connor (1949) also attributed liver damage in infantile diarrhoea to hypothetical toxins, whilst Schlesinger, Payne and Burnard (1949) invoked nutritional deficiency. The 13 cases which form the basis of this report came to necropsy in the Bernhard Baron Institute of the London Hospital in the years 1934 to 1954. They appear essentially similar to those described by Wainwright, although a different interpretation will be placed upon the pathogenesis of the hepatic lesions. Description of Cases