A Safety and Efficacy Study to Determine if Giving Intravenous Fish Oil Helps Children With Liver Disease

Inclusion Criteria: * Clinical evidence of parenteral nutrition associated cholestasis * Direct bilirubin greater or equal to 2 mg/dL on 2 consecutive measurements * Expected parenteral nutrition course greater than 30 days * Acquired or congenital gastrointestinal disease * \> 2 weeks of age and \< 18 years of age * \> 60% calories from parenteral nutrition * Failed standard therapies to prevent progression of liver disease (Actigal, cyclic parenteral nutrition, avoidance of overfeeding, reduction/removal of copper from parenteral nutrition if elevated my laboratory analysis, advancement of enteral feeds) Exclusion Criteria: * Inborn errors of metabolism * Extracorporeal Membrane Oxygenation * Seafood, egg, or Omegaven allergy * Documented case of liver disease other than Parenteral Nutrition Associated Cholestasis * Hemorrhagic disorder * Anticoagulant therapy * Hemodynamically unstable or in shock * Comatose state * Stroke, pulmonary embolism, recent myocardial infarction * Diabetes * Fatal chromosomal disorder * Enrollment in any other clinical trial involving an investigational agent * Patient, parent, or legal guardians unable or unwilling to give consent * Patient expected to be weaned from parenteral nutrition in 30 days * unable to tolerate necessary monitoring * Patient requiring aspirin or toradel or motrin * Patient requiring dialysis