Magnets in the stomach

Abstract

An 11-year-old African American boy with a medical history significant for attention deficit and hyperactivity disorder presented with a 4-day history of intermittent epigastric and periumbilical pain associated with nausea, anorexia, and decreased oral intake. A low-grade fever began the day before admission. Upon further questioning, the patient admitted to swallowing a few days before the onset of the abdominal discomfort multiple small magnets that were pieces of a toy. The patient had a temperature of 100.38F. Other vital signs were within normal limits for his age. Physical examination revealed a tender epigastrium and periumbilical region without guarding or peritoneal signs. The rest of the examination was unremarkable. White blood cell count was elevated. On abdominal x-ray, there was no free air or dilated loops of bowel; however, 3 opaque foreign bodies were seen in the area of the antrum-duodenal junction. Given that the patient showed neither signs of systemic illness nor peritonitis, an abdominal x-ray was repeated the following morning. This showed no change in position of the magnets (Fig. 1). The magnets were presumed to be in the stomach; therefore, an esophagogastroduodenoscopy was performed in an attempt to retrieve the foreign bodies by aid of an