Rare magnets (neodymium magnets) are high-powered magnets known to cause intestinal perforation if the intestinal mucosa is trapped in between 2 or several magnets. A bowel perforation in pediatric patients secondary to magnets is usually managed with a surgical intervention that might require enterectomy. We report a case of an 11-year-old boy who presented with abdominal pain and a finding on abdominal x-ray of radiopaque foreign bodies located in the ascending colon. He underwent colonoscopy with a finding of embedded magnets with a colonic perforation. The colonoscopy revealed embedded magnets in the colonic mucosa that were colonoscopically removed, and then, the perforated site was successfully managed with endoclipping of the perforation site in the ascending colon.
In the pediatric population, Gastric Intestinal Metaplasia (GIM) is a finding with unknown frequency and, more importantly, unknown clinical implications. The relationship between Helicobacter pylori (HP) infection and GIM is well documented, as well as an association between duodenogastric reflux and GIM. We present two cases of pediatric patients with GIM along with a review of the literature. The diagnosis of GIM may have adverse clinical implications and should be made with caution in a child. The association of GIM and adenoma/dysplasia and carcinoma is rarely seen in children, primarily because the time required for these to develop takes the individual into adulthood. Treatment, long-term consequences, and surveillance protocols are not well established in the pediatric population. Studies to evaluate the long-term natural history, treatment, and surveillance protocols in children with GIM are needed.
The pancreatic rest, aberrant, or heterotopic pancreas is a normal function pancreas found in the submucosal layer of the greater curvature of the gastric antrum and occasionally in the duodenum. Most of the patients are asymptomatic and the finding is usually incidental. We describe the case of a child with abdominal pain and history of recurrent ulcers that necessitated esophagogastroduodenoscopy and further evaluation with endoscopic ultrasound that confirmed a submucosal lesion consistent with a pancreatic rest. Endoscopic submucosal dissection was performed without complication, and complete symptom resolution was achieved after dissection of the pancreatic rest.
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