ABSTRACT 780

Abstract

Background and aims: Gastric lactobezoar (GL) is a rare neonatal pathology. Only 96 cases have been described since 1959. It’s a pathological conglomeration of milk and mucus in the stomach of milk-fed infants often causing gastric outlet obstruction. In the NICU of Fort de France (French West Indies), 7 GL appeared since 24.08.13 to 3.10.13 in premature babies whose 3 needs emergency surgery and one baby died. Aims: The aim of this work is to describe the cases and the changes induced by these cases. Methods: All the cases were check by epidemiologists and physicians to detect predisposing factors. In the same time, analyzed of the nutrition process have been made to detect anomalies. IRB approved the study. Results: The GL appeared 18 days after birth when enteral feeding is about 130 ml/kg/d. The firsts symptoms where seen 2.4 days before diagnosis. Abdominal distension, vomiting, regurgitation of curd milk were more frequent and associated in 5 cases. The X-ray image was pathognomonic. Treatment was only medical for 3 cases and surgical in 4 cases. Predisposing factors were prematurity, premature formula milk (PF), enhanced caloric density, association between PF and medium chain triglycerides (TG). Conclusions: LG can be a very serious condition and must be early detect. The diagnosis is difficult because symptoms are common in neonates. We decide to stop association between PF and TG and we are more cautious when there is an association between abdominal distension and vomiting or curd milk regurgitation. Since this analysis and changes, no LG appeared in the NICU.