Combined Aspiration and Ingestion of Multiple Metallic Beads Resulting in Tracheoesophageal Fistula

Abstract

The introduction of magnetic toys has led to an increase in the incidence of pediatric magnet ingestion. A previously healthy 3-year-old girl was referred to our emergency room after ingesting multiple magnets more than a week ago. Although she did not show any subjective symptoms, imaging revealed three metallic foreign bodies in the trachea and upper esophagus, with multiple aggregated foreign bodies in the lower-middle abdomen. A total of 17 magnetic beads were successfully retrieved through operative exploration. A secondary tracheoesophageal fistula was identified during foreign body removal. Based on the size and granulation tissue coverage, the fistula was managed conservatively. The follow-up examination on postoperative day 7 showed spontaneous fistula resolution. Ingestion of multiple magnets may result in fatal consequences due to pressure necrosis of vital organs. Early identification and prompt management are crucial to minimize morbidity in these cases.