Department of Neonatology, Charité - Universitätsmedizin Berlin, Berlin, Germany,
Department of Neonatology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Neonatology. 2019;115(3):211-216. doi: 10.1159/000494625. Epub 2019 Jan 15.
Milk curd obstruction as a cause of intestinal obstruction has been known since 1959, but has nearly disappeared. However, in recent years it has experienced a revival in small premature infants.
The aim of this study was to evaluate the clinical characteristics of milk curd obstruction (lactobezoar) in preterm infants.
Data of preterm infants with milk curd obstruction cared for at a large tertiary neonatal intensive care unit between 2012 and 2016 were retrieved from the electronic registry and paper records.
A total of 10 infants (2 girls, 8 boys) were identified: the median birth weight was 595 g (range 270-922), gestational age was 24.4 weeks (23.4-27.0), weight-for-gestational age percentile was 16 (0-62), and age at diagnosis was 28 days (16-64). Five infants (50%) were small for gestational age. All neonates had received fortified human milk (added protein 2.0 g/100 mL, range 0-2.8; added calcium 2,400 µmol/100 mL, range 0-6 844; added phosphate 2,400 µmol/100 mL, range 0-5,178). Seven neonates underwent surgery, and 2 infants died. Hyperechoic masses in extended bowel loops, visualised by abdominal ultrasound, and pale/acholic faeces were hallmarks of milk curd obstruction.
In this study, milk curd obstruction occurred exclusively in infants with a birth weight < 1,000 g (2.2%) and < 28 weeks' gestational age (2.4%). Male and small for gestational age infants appeared to be at increased risk. Paying attention to the colour of the faeces of infants at risk might help to diagnose milk curd obstruction at an early stage.
自 1959 年以来，人们已经知道奶块阻塞是肠梗阻的一个原因，但它几乎已经消失了。然而，近年来，它在小早产儿中又重新出现。
本研究旨在评估小早产儿的奶块阻塞（乳凝块）的临床特征。
从电子病历和纸质记录中检索了 2012 年至 2016 年期间在一家大型三级新生儿重症监护病房接受奶块阻塞治疗的早产儿的数据。
共确定了 10 名婴儿（2 名女孩，8 名男孩）：中位出生体重为 595 克（范围 270-922），胎龄为 24.4 周（23.4-27.0），体重与胎龄百分位值为 16（0-62），诊断年龄为 28 天（16-64）。5 名婴儿（50%）为小于胎龄儿。所有新生儿均接受强化人乳喂养（添加蛋白质 2.0 g/100 mL，范围 0-2.8；添加钙 2400 µmol/100 mL，范围 0-6844；添加磷酸盐 2400 µmol/100 mL，范围 0-5178）。7 名新生儿接受了手术，2 名婴儿死亡。腹部超声检查显示肠袢扩张的高回声肿块和苍白/淡色粪便都是奶块阻塞的特征。
在本研究中，奶块阻塞仅发生在出生体重<1000 g（2.2%）和<28 周胎龄（2.4%）的婴儿中。男性和小于胎龄儿似乎风险增加。注意高危婴儿的粪便颜色可能有助于早期诊断奶块阻塞。
