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[Gastric perforation caused by a lactobezoar in an infant: a case report]

M Gambart1, S Breinig, A Breton

  • 1Service de réanimation pédiatrique, hôpital des Enfants de Toulouse, 330, avenue de Grande-Bretagne, 31059 Toulouse cedex 9, France.

Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie
|August 14, 2012
PubMed

Insights

Lactobezoars, undigested milk masses, cause gastric outlet obstruction in infants. This rare case involved perforation and necrosis, requiring surgery, but conservative management is often successful with early diagnosis.

Area of Science:

  • Pediatric Surgery
  • Neonatology
  • Gastroenterology

Background:

  • Lactobezoar, a mass of undigested milk, commonly causes gastric outlet obstruction in infants.
  • Risk factors include prematurity, low birth weight, altered gastric function, and specific infant formulas.

Observation:

  • A premature female infant presented with shock, food intolerance, abdominal distension, and sepsis.
  • Imaging revealed a distended stomach with a heterogeneous mass consistent with a lactobezoar and pneumoperitoneum.

Findings:

  • Emergency laparotomy showed gastric perforation and necrosis secondary to a large lactobezoar.
  • Surgical treatment involved lactobezoar extraction, partial gastrectomy, and gastrostomy, followed by prolonged sepsis and NPO status.

Implications:

  • Early diagnosis of lactobezoar in infants with gastrointestinal obstruction is crucial.
  • While surgery is sometimes necessary for complications like perforation, conservative management often leads to good outcomes.
  • Understanding etiopathogenic factors can help prevent lactobezoar formation in high-risk infants.

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