Gastrotomy for lactobezoar in a newborn infant

Wolf, Richard S.; Bruce, James W.

doi:10.1016/s0022-3476(59)80150-5

Cited by 33 publications

(19 citation statements)

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“…They were first described in low birth weight infants in 1959 (Wolf RS, and Bruce J, 1959). Gastric bezoars may be found in asymptomatic patients but usually present with gastrointestinal symptoms, such as abdominal distension, vomiting, regurgitation, gastric residuals or palpable abdominal mass (Heinz-Erian P 2012).…”

Section: Discussionmentioning

confidence: 99%

Gastric Bezoar - A Rare Presentation in Infant

Siddiqui

Alam

Shahinur

et al. 2016

J. paediatr. surg. Bangladesh

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Abstract:Gastric bezoar in neonate is a rare presentation. Because of rarity of phytobezoar and lactobezoar are not considered as the differential diagnosis of a lump and vomiting commonly. A 7 month female presented with left upper abdominal undifferentiated hard mobile lump and post prandial occasional vomiting. Diagnosis was non-conclusive with USG, contrast medium study of stomach and duodenum and contrast enhanced CT scan. After laparotomy and gastrostomy mass was removed and diagnosed as phytolactobezoar on macroscopic appearance

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Section: Discussionmentioning

confidence: 99%

Gastric Bezoar - A Rare Presentation in Infant

Siddiqui

Alam

Shahinur

et al. 2016

J. paediatr. surg. Bangladesh

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“…Bezoar formed by using to concen!trarted milk formulas, caUed lac.tobezoar, were also reported in the litterature (Wolff, 1959;Woliff, 1963;Levkoff et al, 1970;and Majd et aJ., 1972).…”

Section: Introductinnmentioning

confidence: 89%

Phytobezoar

Sundoro

Karjomanggolo

Tamaela

2017

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“…In 2 further patients GLBs were first diagnosed by gastroscopy [19,46] (Table 3). Notwithstanding, in 9 patients GLBs were detected during laparotomy [1,3,12,25]. While gastric perforation was found in 7 of these patients, pneumoperitoneum was identified by plain abdominal X-ray in only 4 of them.…”

Section: Diagnosismentioning

confidence: 99%

Gastric lactobezoar - a rare disorder?

Heinz‐Erian

Gaßner

Klein‐Franke

et al. 2012

Orphanet J Rare Dis

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Gastric lactobezoar, a pathological conglomeration of milk and mucus in the stomach of milk-fed infants often causing gastric outlet obstruction, is a rarely reported disorder (96 cases since its first description in 1959). While most patients were described 1975-1985 only 26 children have been published since 1986. Clinically, gastric lactobezoars frequently manifest as acute abdomen with abdominal distension (61.0% of 96 patients), vomiting (54.2%), diarrhea (21.9%), and/or a palpable abdominal mass (19.8%). Respiratory (23.0%) and cardiocirculatory (16.7%) symptoms are not uncommon. The pathogenesis of lactobezoar formation is multifactorial: exogenous influences such as high casein content (54.2%), medium chain triglycerides (54.2%) or enhanced caloric density (65.6%) of infant milk as well as endogenous factors including immature gastrointestinal functions (66.0%), dehydration (27.5%) and many other mechanisms have been suggested. Diagnosis is easy if the potential presence of a gastric lactobezoar is thought of, and is based on a history of inappropriate milk feeding, signs of acute abdomen and characteristic features of diagnostic imaging. Previously, plain and/or air-, clear fluid- or opaque contrast medium radiography techniques were used to demonstrate a mass free-floating in the lumen of the stomach. This feature differentiates a gastric lactobezoar from intussusception or an abdominal neoplasm. Currently, abdominal ultrasound, showing highly echogenic intrabezoaric air trapping, is the diagnostic method of choice. However, identifying a gastric lactobezoar requires an investigator experienced in gastrointestinal problems of infancy as can be appreciated from the results of our review which show that in not even a single patient gastric lactobezoar was initially considered as a possible differential diagnosis. Furthermore, in over 30% of plain radiographs reported, diagnosis was initially missed although a lactobezoar was clearly demonstrable on repeat evaluation of the same X-ray films. Enhanced diagnostic sensitivity would be most rewarding since management consisting of cessation of oral feedings combined with administration of intravenous fluids and gastric lavage is easy and resolves over 85% of gastric lactobezoars. In conclusion, gastric lactobezoar is a disorder of unknown prevalence and is nowadays very rarely published, possibly because of inadequate diagnostic sensitivity and/or not yet identified but beneficial modifications of patient management.

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Gastrotomy for lactobezoar in a newborn infant

Cited by 33 publications

References 0 publications

Gastric Bezoar - A Rare Presentation in Infant

Gastric Bezoar - A Rare Presentation in Infant

Phytobezoar

Gastric lactobezoar - a rare disorder?

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