Small bowel complication caused by magnetic foreign body ingestion of children: two case reports

Chung, Jae Hee; Kim, Jeong Soo; Song, Young Woo

doi:10.1016/s0022-3468(03)00514-1

Cited by 81 publications

(54 citation statements)

References 3 publications

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“…Intestinal perforations resulting from multiple magnets have been reported from Southeast Asian countries, where magnets are widely used to relieve musculoskeletal pain [6,7]. In our patient, the magnet was attracted to the steel ball, and the alkaline disc battery was attracted to this across a loop of ileum, causing adherence and impaction.…”

Section: Discussionmentioning

confidence: 69%

Multiple foreign body ingestion and ileal perforation

Nagaraj

Sunil

2005

Ped Surgery Int

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Foreign body ingestion is a common problem encountered in the pediatric age group. The swallowed object is often passed with little or no morbidity. Problems ensue if the ingested foreign body is hazardous, is multiple, or becomes impacted. We describe an ileal perforation following the ingestion of an alkaline disc battery, a magnet, and a steel ball impacted in the ileum for about 48 h. The magnet and the steel ball were attracted to each other, forming a composite unit. The disc battery and the magnet were attracted to each other across a loop of ileum, causing necrosis and perforation of the ileum.

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Section: Discussionmentioning

confidence: 69%

Multiple foreign body ingestion and ileal perforation

Nagaraj

Sunil

2005

Ped Surgery Int

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“…If clinically undetected, the pressure necrosis of the intervening tissue will eventually lead to perforation and/or enteroenteric fistula formation. This is the most common finding in patients who swallow multiple magnets with 91% (10/11) of children previously reported in the literature having developed an enteroenteric fistula, or bowel perforation [6][7][8][9][10][11][12][13][14].…”

Section: Discussionmentioning

confidence: 99%

“…In review of the previously published case reports, 100% (11/11) of children had a radio-opaque foreign object observed on abdominal imaging [6][7][8][9][10][11][12][13][14]. Additionally, 82% (9/11) also demonstrated radiographic evidence of intestinal obstruction (dilated loops of bowel and/or air-fluid levels), and 45% (5/11) had a line of multiple radio-opaque objects concerning for magnets.…”

Section: Discussionmentioning

confidence: 99%

Magnetic attraction leading to a small bowel obstruction in a child

et al. 2007

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Foreign body ingestion in small children is common yet only 1% of cases require operative management of associated complications (Arana et al. in Eur J Pediatr 160:468-472, 2001). A 6-year-old boy was referred to our institution with a 12 h history of abdominal pain. This pain was diffuse and crampy in nature and associated with multiple episodes of non-bilious, non-bloody emesis. On evaluation he was stable and his abdomen demonstrated slight distention and tenderness without peritoneal signs. Plain abdominal radiographs demonstrated some distended loops of small bowel and a radio-opaque foreign object within the mid-abdomen. A small bowel obstruction secondary to foreign body ingestion was diagnosed and an emergent laparotomy performed. Upon exploration, a transition zone was noted near the ileocecal valve. Further exploration revealed the obstruction to be caused secondary to the apposition of two small (8 mm) magnets, one in the proximal ileum and the other near the ileocecal valve, resulting in an internal hernia. The magnets were easily separated relieving the obstruction and both were removed via two small bowel enterotomies. After being presented with the magnets, his parents suspected that they came from the clothes of a Polly Pocket (Mattel, Inc., El Segundo, CA) doll. The patient had an uneventful post-operative course and was discharged to home on the second post-operative day. This case demonstrates the complications that may occur with multiple magnet ingestion. It highlights the need for close observation and early surgical intervention in children with a suspected history of foreign body ingestion, a clinical picture of gastrointestinal distress, and radiographic evidence of a radio-opaque foreign object.

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“…Çoklu mıknatıs ya da tek mıknatısla birlikte mıkna-tıslanabilen metalik cisimlerin yutulması ve bu cisimlerin bir araya gelerek mide veya bağırsak duvarları-nı aralarına sıkıştırması durumunda basıya bağlı tıka-nıklık, nekroz ve fistül gibi komplikasyonların yanı sıra invajinasyon ve apse görüldüğü rapor edilmiştir. [5][6][7][8][9] Bu durumda olgu akut karın bulguları ile başvura-bilir. Fakat eğer yabancı cisim yutma ile ilgili bir öykü yoksa ve dikkatli bir fiziksel inceleme, radyolojik değerlendirme yapılmazsa yanlış tanı ile ameliyata alı-nan hasta ameliyat sırasında hekimi zor durumda bı-rakabilir.…”

Section: Discussionunclassified

Intestinal Perforation Due To Multiple Magnet Ingestion: A Case Report

Cevizci¹,

Karadağ²,

Demir³

et al. 2012

Ulus Travma Acil Cerrahi Derg

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Çocukluk döneminde çoklu mıknatıs yutma acil durumlara yol açabilir. Bir mıknatıs yutulduğunda çoğunlukla bağırsak pasajı ile atılırken, birden fazla mıknatıs olduğunda, birbirine yapıştığından önemli bağırsak komplikasyonlarına neden olabilir. Burada çoklu mıknatıs ve metal maddeler yutulması sonrasında gelişen çoklu bağırsak perforasyonu olgusu sunuldu. Sekiz yaşında kız hasta karın ağrısı ve kusma şika-yetiyle başvurdu. Başvuru sırasında karın hassasiyeti ve defansı mevcuttu. Düz grafide hava-sıvı seviyeleri ve metalik cisimler gözlendi. Grafide görülen metalik cisimler tanısal yönden dikkate alınmadı. Karın ultrasonografisi akut apandisit lehine rapor edildi. Eksplorasyonda appendiks normal olarak görüldü fakat çekum ve ileum sıkı bir şekilde yapışık bulundu. Diseksiyon sonrasında çekumda, çekumun 15 ve 45 cm proksimalinde internal fistüller yapan bağırsak perforasyonları gözlendi. Belirgin bağırsak kaçağı ve buna bağ-lı peritonit bulgusu yoktu. Bu alandaki yapışıklıklar ayrıldı-ğında mıknatıs parçaları ve metal cisimler görüldü. Bağır-sak yaralanmaların birinde kama rezeksiyon, diğerlerinde primer tamir uygulandı. Ameliyattan sonra sorun yaşanma-dı, hasta 5. gün şifa ile taburcu edildi. Çocuk cerrahları birden fazla mıknatısın yutulması komplikasyonlarının bilincinde olmalıdır. Yabancı cisim yutulması hikayesi mevcut olgularda abdominal düz grafilerle hasta takibi yapılmalı, beraberinde mıknatıslanabilen metal cisim veya çoklu mık-natıs yutulması durumunda olası komplikasyonları önlemek için cismin yerleşimine bakılmadan çıkarılmalıdır.Anahtar Sözcükler: Bağırsak; mıknatıs; metal; perforasyon; yabancı cisim.Multiple magnet ingestion during childhood may result in emergency situations. A single magnet may be discharged with intestinal peristalsis, but multiple magnets may stick together and cause significant intestinal complications. Here we present a case with intestinal perforation due to ingestion of multiple magnets and metal pieces. An eightyear-old girl presented with abdominal pain and vomiting. She had abdominal tenderness and defense on the physical examination. Abdominal X-ray showed air and fluid levels. Metallic images were not considered at first as important in the diagnosis. Abdominal ultrasonography was reported as acute appendicitis. During the abdominal exploration, the appendix was normal, but there were dense adherences around the ileum and cecum. After adhesiolysis, intestinal perforations were seen in the cecum and 15 and 45 cm proximal to the cecum. Magnet and metal pieces were present in the perforated segments. Wedge resection and primary repair was performed. There were no postoperative complications, and she was discharged on the postoperative fifth day. Pediatric surgeons should be aware of the complications of multiple magnet ingestion. If the patient has a history of multiple magnet ingestion, follow-up with daily abdominal X-rays should be done, and in cases where magnets seem to cluster together or if acute abdominal signs develop, surgical exploration should be considered.

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Small bowel complication caused by magnetic foreign body ingestion of children: two case reports

Cited by 81 publications

References 3 publications

Multiple foreign body ingestion and ileal perforation

Multiple foreign body ingestion and ileal perforation

Magnetic attraction leading to a small bowel obstruction in a child

Intestinal Perforation Due To Multiple Magnet Ingestion: A Case Report

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