Findings recorded from obliterative hepatic endophlebitis are described in this paper and are compared with international literature. They had been obtained from a male twin who had died with clinical symptoms of hepatic failure. Differential diagnosis of liver insufficiency in early childhood is discussed in some detail. Also recorded was obliterative angiitis of intramural blood vessels in the ileum. Systemic vasculitis is postulated, possibly developed on the basis of an immunological reaction. Intra-uterine infection had probably been the most likely cause.