Neonatal Presentation of Congenital Portosystemic Shunt

A growth restricted neonate was born at 34 weeks gestation with a birth weight of 1.28 kilograms to a 33-year-old female with unremarkable pre-natal labs. During his first six weeks of life in the Neonatal Intensive Care Unit (NICU), he demonstrated persistent hypoglycemia requiring continuous enteral feeding, oral feeding immaturity, respiratory insufficiency, cholestasis, elevated liver enzymes and hyperammonemia. In addition, he had a history of anemia, thrombocytopenia and coagulopathy requiring packed red blood cell, platelet, fresh frozen plasma and cryoprecipitate transfusions.

source https://www.jpeds.com/article/S0022-3476(21)00976-8/fulltext?rss=yes