Keto-Bezoar: Adverse Event Related to Initiation of Ketogenic Diet in an Infant

The paper is a case report of a 6-week-old infant with drug-resistant epilepsy started on a high-ratio ketogenic diet (4.5:1) on day of life 27. Two weeks later, the infant developed abdominal distention, feed intolerance, and abnormal stools. The authors discuss this as a previously undocumented adverse event of the ketogenic diet in infants, hypothesizing that the high fat content and the patient's young age may have contributed to bezoar formation due to immature fat metabolism. Limitations include the single-case nature, lack of chemical analysis of the bezoar, and inability to definitively prove causation, though other anatomical causes were ruled out.