Abstract
Foreign body ingestion is a common reason for seeking emergency care among children. One of the more serious foreign bodies are the ingestion of multiple magnets or concurrent ingestion of a magnet and a metallic foreign body. Conservative management with serial imaging can be misleading in such cases. Multiple magnets tend to have strong attractive forces among them and may encase loops of bowel within them. Once entrapped, pressure necrosis and perforation will ensue, and thus, a low threshold should be adopted for surgical exploration in such cases. We present the case of a two-year-old male who had an accidental, unwitnessed ingestion of multiple magnets and also report the subsequent surgical management and associated morbidity
Highlights
Ingestion of multiple magnets is a serious health hazard for children, with an extremely high risk of intestinal obstruction and perforation in comparison with single magnet ingestion or other non-magnetic foreign bodies, the latter being most common
Magnets in plurality tend to capture loops of bowel in between them, which leads to localized necrosis and perforation
In a recent 10-year retrospective review conducted in the USA, on an average, 16,386 patients present to the emergency department with possible magnet ingestion
Summary
Ingestion of multiple magnets is a serious health hazard for children, with an extremely high risk of intestinal obstruction and perforation in comparison with single magnet ingestion or other non-magnetic foreign bodies, the latter being most common. We present a two-year-old male with un-witnessed ingestion of eleven magnets leading to gut perforation at multiple levels. He was kept nil per oral and started on total parental nutrition and tramadol infusion. The child was later readmitted with persistent vomiting on the 11th post-operative day and managed as subacute intestinal obstruction. He was kept nil per oral, and an abdominal X-ray was repeated, which revealed fecal loading in large bowel (Figure 4). He underwent therapeutic water-soluble contrast administration and subsequently improved. He was discharged on regular laxatives and he remained asymptomatic on subsequent follow-up visits
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