A new and unusual roentgenographic finding of fatty liver in infants

A new roentgenographic sign, the 'radiolucent liver', secondary to extensive fatty degeneration of the liver is presented in 2 infants. In one infant the cause of liver damage was not completely ascertained (although infectious or toxic hepatitis was postulated) while kwashiorkor was the problem in the second infant. The radiolucent liver sign is quite striking roentgenographically and is probably specific for extensive fatty replacement of the liver. Both the infants died shortly after the roentgenographic and clinical findings were documented, and although it is not believed that one can unequivocally attach prognostic significance to this sign, it does seem to be associated with very extensive end stage fatty replacement of the liver, probably well beyond significant recovery.