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Case Reports in Pediatrics
Volume 2012 (2012), Article ID 412412, 3 pages
http://dx.doi.org/10.1155/2012/412412
Case Report

Neonatal Gastric Lactobezoar: Management with N-Acetylcysteine

1Department of Pediatrics, University of Florida, Jacksonville, FL 32209, USA
2Division of Neonatology, Wolfson Children’s Hospital, Jacksonville, FL 32209, USA
3Division of Pediatric Gastroenterology, Nemours Children’s Clinic, Jacksonville, FL 32209, USA

Received 16 October 2012; Accepted 18 November 2012

Academic Editors: E. Barbi, M. Ehlayel, A. C. Lee, A. Mohta, M. Moschovi, A. E. Scaramuzza, and A. T. Soliman

Copyright © 2012 Sarah Bajorek et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Gastric lactobezoars (GLBs) are the most common form of bezoars in neonates and consist of aggregations of undigested milk constituents. GLB can present with a variety of intra-abdominal clinical symptoms, and occasionally, extra-abdominal symptoms. Conservative management, with a period of bowel rest and intravenous fluids, is the most common treatment regimen for uncomplicated GLB. Surgical measures are reserved for the rare complications of obstruction and/or perforation. Although limited, utilization of the protein-cleaving enzyme N-acetylcysteine has been described for the disintegration of GLB in toddlers. In this paper, we discuss the first documented use of N-acetylcysteine for a neonatal GLB. Supporting literature, the infant’s unusual presentation, and details of the treatment regimen are discussed.