|
1
|
Ignatiev VV, Muraviev AV, Garapov TA, Tishukov MY. [Magnetic foreign bodies of the gastrointestinal tract in pediatric practice]. Khirurgiia (Mosk) 2024:29-37. [PMID: 38477241 DOI: 10.17116/hirurgia202403129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
OBJECTIVE To analyze the pediatric patients with multiple magnetic foreign bodies of the gastrointestinal tract undergoing surgical intervention; to present the treatment and diagnostic algorithm in pediatric practice; to compare surgical interventions for these lesions and determine the most optimal one. MATERIAL AND METHODS A retrospective single-center study included 9 patients diagnosed with multiple magnetic foreign bodies of the gastrointestinal tract. Exclusion criteria: outpatient cases and endoscopic removal of magnetic foreign bodies. All patients underwent laparoscopy and/or laparotomy. We analyzed postoperative data and determined the preferable approach. RESULTS All patients were discharged without complications. Length of hospital-stay was shorter after laparoscopy (7 vs. 12 days). Patients after laparoscopy didn't need for intensive care while laparotomy required ICU stay for 4.5±2.2 days. Enteral feeding started after 1 and 3 days, respectively. CONCLUSION Laparoscopy is preferable for multiple magnetic foreign bodies of the gastrointestinal tract due to shorter hospital-stay, no need for ICU-stay, lower surgical trauma and earlier enteral feeding.
Collapse
Affiliation(s)
- V V Ignatiev
- Sevastopol City Hospital No. 5 - Center for Maternal and Child Health, Sevastopol, Russia
| | - A V Muraviev
- Sevastopol City Hospital No. 5 - Center for Maternal and Child Health, Sevastopol, Russia
| | - T A Garapov
- Sevastopol City Hospital No. 5 - Center for Maternal and Child Health, Sevastopol, Russia
- Pirogov Sevastopol City Hospital No. 1, Sevastopol, Russia
| | | |
Collapse
|
|
2
|
Kathayat LB, Chalise A, Maharjan JS, Bajracharya J, Shrestha R. Intestinal Perforation with Ingestion of Blunt Foreign Bodies: A Case Report. JNMA J Nepal Med Assoc 2022; 60:817-820. [PMID: 36705133 PMCID: PMC9794934 DOI: 10.31729/jnma.7650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 08/25/2022] [Indexed: 01/31/2023] Open
Abstract
Foreign body ingestions are fairly common and present with obvious symptoms. Certain foreign bodies, like button batteries and magnets, are rarely ingested, but carry with them the extremely dangerous risk of bowel wall necrosis, intestinal perforation and fistula formation. Suspected cases of such ingestions require a high index of suspicion and any delay should be avoided once a diagnosis is made. Herein, we report a case of a 7-year-male patient who presented with abdominal pain and vomiting following similar foreign body ingestion, which resulted in multiple small bowel perforations. The foreign body was removed by a laparotomy, and the affected bowel segments were resected and anastomosed. The patient made an uneventful recovery and was discharged after 5 days.
Collapse
Affiliation(s)
- Lok Bahadur Kathayat
- Department of Surgery, Nepal Medical College and Teaching Hospital, Jorpati, Kathmandu, Nepal
| | - Anup Chalise
- Department of Surgery, Nepal Medical College and Teaching Hospital, Jorpati, Kathmandu, Nepal
| | - Jemesh Singh Maharjan
- Department of Surgery, Nepal Medical College and Teaching Hospital, Jorpati, Kathmandu, Nepal
| | - Jasmine Bajracharya
- Department of Paediatric Surgery, Nepal Medical College and Teaching Hospital, Jorpati, Kathmandu, Nepal
| | - Ritesh Shrestha
- Department of Paediatric Surgery, Nepal Medical College and Teaching Hospital, Jorpati, Kathmandu, Nepal
| |
Collapse
|
|
3
|
Oh RG, Lee CG, Park YN, Lee YM. Successful removal of two magnets in the small intestine by laparoscopy and colonoscopy: A case report. World J Clin Cases 2021; 9:8226-8231. [PMID: 34621885 PMCID: PMC8462221 DOI: 10.12998/wjcc.v9.i27.8226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/24/2021] [Accepted: 08/02/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Ingestion of multiple magnets can cause serious gastrointestinal complications, such as obstruction, fistulae, and perforation. When multiple magnets traverse the stomach, coordination between pediatric gastroenterologists and pediatric surgeons is recommended, and ultimate management is required dependent on clinical concerns.
CASE SUMMARY A 5-year-old girl swallowed 2 small magnets that then remained in the right lower quadrant (RLQ) of the abdomen for 3 d; this required endoscopic and laparoscopic intervention. Abdominal X-ray and computed tomography revealed high-density objects in the RLQ area. Colonoscopy after proper bowel preparations on the third day of ingestion revealed no foreign body in the colonic area or the end of the ileum. The two magnets were removed via colonoscopy with laparoscopic intervention.
CONCLUSION It is important to establish effective coordination between pediatric gastroenterologists and pediatric surgeons when using a non-invasive procedure to remove magnets.
Collapse
Affiliation(s)
- Ryang Geun Oh
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Bucheon 14584, South Korea
| | - Cheol Gu Lee
- Department of Surgery, Soonchunhyang University Bucheon Hospital, Bucheon 14584, South Korea
| | - You Na Park
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Bucheon 14584, South Korea
| | - Yoo Min Lee
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Bucheon 14584, South Korea
| |
Collapse
|
|
4
|
Autistic child with abdominal pain caused by foreign body ingestion. JOURNAL OF SURGERY AND MEDICINE 2020. [DOI: 10.28982/josam.729782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
|
5
|
Multiple magnet ingestion: Ring-like configuration with multiple intestinal fistulae. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2020. [DOI: 10.1016/j.epsc.2020.101472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
|
|
6
|
Abstract
PURPOSE OF REVIEW Pediatric foreign body ingestion is a common occurrence that presents a challenge both to pediatric gastroenterologists and primary care providers. Increasing prevalence of smaller, more technologically advanced toys in the household has resulted in an increased exposure to higher voltage batteries and powerful magnets that carry a high incidence of morbidity and mortality. This review highlights the latest findings regarding the patients at risk for button battery and magnet ingestions, the symptoms of presentation, and complications of these objects in contributing to long-standing gastrointestinal injury. RECENT FINDINGS Button batteries may lead to esophageal injury within a few hours. Batteries retained in the esophagus are larger in diameter on average and size is associated with esophageal impaction as well as higher grade esophageal injury. Magnet ingestions, when multiple or with another metallic object, are often initially asymptomatic but may have acute worsening, and therefore warrant close monitoring. SUMMARY Button battery and magnet ingestions have increased in incidence over the past two decades. Recent literature demonstrates that higher voltage, larger lithium button batteries, and prevalence of high-powered magnets can lead to significant morbidity. High suspicion, early referral, and removal may lead to improved outcomes.
Collapse
|
|
7
|
Tanrikulu Y, Tanrikulu CS, Karaman S, Sahin H. Ingestion of Multiple Magnets for Suicide. HONG KONG J EMERG ME 2015. [DOI: 10.1177/102490791502200107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Foreign objects ingestion, either intentionally or accidentally, is a well-known problem in paediatric population. However, it is not uncommonly seen in adult especially in patients with psychiatric disorders and prisoners. We presented a case in which a seventeen year-old young man attended emergency department after attempting suicide by cutting his wrist. Incidentally, he was found to have ingested multiple magnets which stayed in the stomach. Removal by endoscopic method was failed. Surgical removal of a total of thirty-three magnets through a surgical gastrostomy was performed. (Hong Kong j.emerg.med. 2015;22: 50-52)
Collapse
|
|
8
|
Unique method to manage ingested magnets. J Pediatr Gastroenterol Nutr 2013; 57:e8. [PMID: 23459319 DOI: 10.1097/mpg.0b013e31828f2005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
|
9
|
Abstract
BACKGROUND AND OBJECTIVE The ingestion of multiple magnets simultaneously or the placement of magnets in both nares can lead to serious injury resulting from the attraction of the magnets across the tissues. The impact of mandatory standards for toys containing magnets has not been thoroughly investigated. The aim of the present study was to describe the emergency department (ED) visit rate for magnet-related injuries. METHODS We performed a retrospective study of children evaluated for magnet-related injuries from 1995 to 2012 in an urban tertiary care pediatric ED. We identified cases using a computerized text-search methodology followed by manual chart review. We included children evaluated for magnet ingestion or impaction in the ears, nose, vagina, or rectum. We assessed the type and number of magnets as well as management and required interventions. A Poisson regression model was used to analyze rates of injury over time. RESULTS We identified 112 cases of magnet injuries. The median patient age was 6 years (IQR 3.5, 10), and 54% were male. Compared to before 2006, the rate for all magnet-related injuries in 2007-2012 (incidence rate ratio 3.44; 95% confidence interval 2.3-5.11) as well as multiple magnet-related injuries (incidence rate ratio 7.54; 95% confidence interval 3.51-16.19) increased. Swallowed magnets accounted for 86% of the injuries. Thirteen patients had endoscopy performed for magnet removal (12%), and 4 (4%) had a surgical intervention. Magnets from toys account for the majority of the injuries. CONCLUSIONS The number of ED visits for magnet-related injuries in children may be rising and are underreported, with an increase in the proportion of multiple magnets involvement. In our case series, mandatory standard for toys had no mitigating effect.
Collapse
|
|
10
|
Flores Pérez P, Luis Huertas A, Villalobos Pinto E, Pérez Martín M, Souto Romero H, de Mingo Micena L. Complicaciones gastrointestinales graves tras la ingesta de un juguete magnético. An Pediatr (Barc) 2013; 78:62-3. [DOI: 10.1016/j.anpedi.2012.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Revised: 03/22/2012] [Accepted: 05/07/2012] [Indexed: 11/29/2022] Open
|
|
11
|
Liu S, Li J, Lv Y. Gastrointestinal damage caused by swallowing multiple magnets. Front Med 2012; 6:280-7. [DOI: 10.1007/s11684-012-0207-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Accepted: 05/18/2012] [Indexed: 12/30/2022]
|
|
12
|
Bailey JR, Eisner EA, Edmonds EW. Unwitnessed magnet ingestion in a 5 year-old boy leading to bowel perforation after magnetic resonance imaging: case report of a rare but potentially detrimental complication. Patient Saf Surg 2012; 6:16. [PMID: 22813210 PMCID: PMC3468355 DOI: 10.1186/1754-9493-6-16] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Accepted: 07/19/2012] [Indexed: 11/16/2022] Open
Abstract
Background The ingestion of non-food items in children is a relatively common event, often unwitnessed, unknown, and unreported. For those children brought in for medical evaluation, less than 10% require intervention, and only 1% require surgery. This, however, is not the case for magnet ingestion. Magnets, in plurality, can become attracted to one another through intestinal walls, causing a variety of surgical emergencies. Case presentation We present a case of unwitnessed multiple magnet ingestion in a 5 year-old boy who presented to the emergency department with the atypical chief complaint of neck pain. The diagnostic work-up including a neck magnetic resonance imaging (MRI) potentially led to bowel perforations managed definitely by a subsequent exploratory laparotomy. The child had an uneventful postoperative recovery and was discharged to home upon surgical recovery. Conclusions Institutions should make all possible efforts to attempt to prevent such potential life-threatening circumstances. We propose a screening tool that can further enhance the care of children who cannot or do not report unwitnessed magnetic ingestion prior to MRI evaluation.
Collapse
Affiliation(s)
- James R Bailey
- Department of Orthopedics/Scoliosis/Sports Medicine, Rady Children's Hospital, 3030 Children's Way, Ste 410, San Diego, CA 92123, USA.
| | | | | |
Collapse
|
|
13
|
Oh HK, Ha HK, Shin R, Ryoo SB, Choe EK, Park KJ. Jejuno-jejunal fistula induced by magnetic necklace ingestion. JOURNAL OF THE KOREAN SURGICAL SOCIETY 2012; 82:394-6. [PMID: 22708104 PMCID: PMC3373992 DOI: 10.4174/jkss.2012.82.6.394] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2011] [Revised: 01/03/2012] [Accepted: 01/19/2012] [Indexed: 12/21/2022]
Abstract
We describe the case of a 19-year-old mentally challenged woman who developed jejuno-jejunal fistula following ingestion of a magnetic necklace. This case report demonstrates the necessity of prompt treatment when the ingested intestinal foreign body is suspected to be multiple magnets, even if there are no sharp edges; and even when it seems the object could be evacuated spontaneously. Ingested magnets are capable of attracting each other across the bowel wall, leading to serious intestinal complications such as pressure necrosis, perforation, fistula formation, or intestinal obstruction.
Collapse
Affiliation(s)
- Heung-Kwon Oh
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | | | | | | | | | | |
Collapse
|
|
14
|
Naji H, Isacson D, Svensson JF, Wester T. Bowel injuries caused by ingestion of multiple magnets in children: a growing hazard. Pediatr Surg Int 2012; 28:367-74. [PMID: 22127484 DOI: 10.1007/s00383-011-3026-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/14/2011] [Indexed: 12/21/2022]
Abstract
PURPOSE There are no definite guidelines on the management of ingested magnetic objects in children. The aim of this study was to present our experience and to highlight the importance of strict follow-up. METHODS Within 6 months period, four children presented to the emergency department after ingestion of multiple magnets. We reviewed retrospectively the patients' documents, radiological reports, operative findings and outcome. We also performed a literature search for all reports of multiple magnets ingestion on MEDLINE and EMBASE. RESULTS Daily abdominal radiographs to monitor migration of magnetic objects together with clinical examination revealed early detection of perforations in two patients. Explorative laparoscopy and suturing of perforations resulted in a rapid recovery and good cosmetic appearance. Literature search resulted in 44 published articles with a total of 52 cases of multiple magnet ingestion in children. CONCLUSIONS This report stresses the need for prompt follow-up and early detection of complications in order to operate those patients without delay. Laparoscopy is the method of choice in exploring the abdomen when perforation is suspected.
Collapse
Affiliation(s)
- Hussein Naji
- Astrid Lindgren Children's Hospital, Karolinska University, Stockholm, Solna, Sweden.
| | | | | | | |
Collapse
|