Abstract
Introduction Foreign body ingestion is a common pediatric complain, and most can be passed spontaneously; however, magnetic object ingestion is rather rare, and they can cause severe complications when multiple magnets are ingested, as they lead to entrapment of bowel walls between them, causing ischemia, pressure necrosis, perforation, and fistula formation. Case Presentation. Herein, we present a case of a 16-month-old female patient presented to our department complaining of continuous vomiting for two days along with fever and irritability. X-ray revealed dilated bowel loops with a radioopaque foreign body in the right lower quadrant. After discussing with the parents, exploratory laparotomy was done, showing two bowel perforations at the site of the magnets. Affected bowel was resected with anastomosis. The patient was discharged after 3 days with an uneventful recovery. Discussion. The diagnosis and management of magnet ingestion differ from those of small foreign bodies, which are usually managed conservatively by watchful waiting. Usually, the diagnosis is done due to complications such as peritonitis and death. On the other hand, management depends on the number, size, magnetic field, and shape of the magnet, and whether it has passed the pylorus or not. Conclusion It is important to establish the diagnosis of this condition as early as possible to prevent complications. Despite the efforts that were made to try to prevent and minimize the risk of magnet ingestion, more investigations are required to reach a common and united strategy for management of such conditions.
Highlights
Foreign body ingestion is a common pediatric complain, and most can be passed spontaneously; magnetic object ingestion is rather rare, and they can cause severe complications when multiple magnets are ingested, as they lead to entrapment of bowel walls between them, causing ischemia, pressure necrosis, perforation, and fistula formation
Foreign body ingestion in children is a common condition, in those aged between 6 months and 3 years [1]
A single magnet is expected to behave like other foreign bodies; the harm risk is escalated when more than one magnetic object is swallowed and passed beyond the stomach since the pieces might hold the bowel wall in between them resulting in ischemia, pressure necrosis, perforation, and fistula formation [5]
Summary
Foreign body ingestion in children is a common condition, in those aged between 6 months and 3 years [1]. As most ingested objects are small, they pass spontaneously, and it is estimated that 40% of foreign body ingestions go unnoticed without showing any signs and symptoms [2]. Once the foreign body reaches the small intestine, in 80-90% of cases, the object passes spontaneously; some cases may be complicated by intestinal obstruction, volvulus, intussusception, and perforation [3]. A single magnet is expected to behave like other foreign bodies; the harm risk is escalated when more than one magnetic object is swallowed and passed beyond the stomach since the pieces might hold the bowel wall in between them resulting in ischemia, pressure necrosis, perforation, and fistula formation [5]. When there is evidence of multiple magnetic foreign body ingestion, our patients should be managed aggressively to prevent complications. A midline laparotomy should be used as the incision of choice to facilitate access [3]
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