Journal List > Korean J Pediatr Gastroenterol Nutr > v.14(3) > 1043516

Korean J Pediatr Gastroenterol Nutr. 2011 Sep;14(3):299-304. Korean.
Published online September 30, 2011.  https://doi.org/10.5223/kjpgn.2011.14.3.299
Copyright © 2011 The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition
A Case of Magnet Ingestion in a Child with Autism: Gastro-Colonoscopic Removal without Surgical Complication
Joo Whee Kim, M.D., Mi Sun Lim, M.D., Soon Chul Kim, M.D., Eun Hye Lee, M.D., Jae Sung Ko, M.D. and Jeong Kee Seo, M.D.
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.

Corresponding author (Email: jkseo@snu.ac.kr )
Received August 19, 2011; Revised August 31, 2011; Accepted September 06, 2011.

Abstract

With the increasing use of magnets in toys, magnet ingestion is becoming a serious problem in children. Two or more magnets may attract across the gastrointestinal tract leading to pressure necrosis, perforation, fistula, volvulus or obstruction. We report a case of a 12-year-old boy with autism who presented with vomiting during seven days due to ingestion of 14 magnetic rods. Under general anesthesia, 5 of 14 magnets were removed from the second portion of the duodenum using a magnetic probe during endoscopy. The remaining magnets were not visible in the duodenum. A plain radiograph taken the next day revealed that the remaining magnets were impacted in the descending-sigmoid junction. One magnet passed spontaneously. However the other 8 magnets did not pass through the junction for 7 days. Five of 8 impacted magnets were removed by a colonoscopic procedure. After 2 hours of colonoscopy, one by one, the remaining three magnets spontaneously passed.

Keywords: Foreign body; Removal; Gastrointestinal endoscopy; Magnet; Children; Colonoscopy

Figures


Fig. 1
Serial plain radiographs of the abdomen demonstrate foreign bodies. Five magnetic rods were found in the 2nd portion of the duodenum and removed by endoscopy performed on the 6th of August. After ten days, colonoscopy was performed and 5 of the remaining magnets were successfully removed; they were linearly stuck to each other and firmly impacted in the descending sigmoid junction.
Click for larger image


Fig. 2
Magnetic probe and attached magnetic rods are seen on endoscopic findings (A) and photography (B).
Click for larger image


Fig. 3
There was a colonoscopic finding of impacted magnets in the descending colon (A). The remaining three magnets spontaneously passed through (B).
Click for larger image

References
1. Centers for Disease Control and Prevention. Gastrointestinal injuries from magnet ingestion in children - United States, 2003-2006. MMWR Morb Mortal Wkly Rep 2006;55:1296–1300.
2. Lee WH, Min YD, Moon KR. A case of gastroduodenal fistula caused by ingested magnetic foreign bodeis. Korean J Pediatr Gastroenterol Nutr 2008;11:84–88.
3. Kwak BG, Moon JS, Jang HO, Nam SY, Kim DW, Lee CG, et al. Small bowel-mesentery-small bowel fistula caused by ingested magnets. Korean J Pediatr Gastroenterol Nutr 2005;8:60–63.
4. Kim MJ, Kwak AJ, Choi KH. Gastric ulcer due to three magnets ingestion in a 37-month-old girl. Korean J Pediatr Gastroenterol Nutr 2002;5:68–72.
5. Seo JK. Endoscopic management of gastrointestinal foreign bodies in children. Indian J Pediatr 1999;66 1 Suppl:S75–S80.
6. Ohno Y, Yoneda A, Enjoji A, Furui J, Janematsu T. Gastroduodenal fistula caused by ingested magnets. Gastrointest Endosc 2005;61:109–110.
7. Seo JK. Endoscopic management of gastrointestinal foreign bodies in children:a clinical practice guideline. Korean J Pediatr Gastroenterol Nutr 2007;10 Suppl 1:64–69.
8. Hwang JB, Park MH, Choi SO, Park WH, Kim AS. How strong construction toy magnets are! A gastro-gastro-duodenal fistula formation. J Pediatr Gastroenterol Nutr 2007;44:291–292.
9. Chung JH, Kim JS, Song YT. Small bowel complication caused by magnetic foreign body ingestion of children. J Pediatr Surg 2003;38:1548–1550.
10. Cauchi JA, Shawis RN. Multiple magnet ingestion and gastrointestinal morbidity. Arch Dis Child 2002;87:539–540.
11. Kubota Y, Tokiwa K, Tanaka S, Iwai N. Intestinal obstruction in an infant due to magnet ingestion. Eur J Pediatr Surg 1995;5:119–120.
12. Nui A, Hirama T, Katsuramaki T, Maeda T, Meguro M, Nagayama M, et al. An intestinal volvulus caused by multiple magnet ingestion: an unexpected risk in children. J Pediatr Surg 2005;40:e9–e11.
13. Chang YS, Song JY, Choi SI. Ileal perforation caused by ingestion of multiple magnets. J Korean Surg Soc 2009;76:270–272.
14. Shah SK, Tieu KK, Tsao K. Intestinal complications of magnet ingestion in children from the pediatric surgery perspective. Eur J Pediatr Surg 2009;19:334–337.
15. Canadian Paediatric Surveillance Program. Magnets in the bowel: a sticky problem!. Paediatr Child Health 2008;13:118.
16. Lake JP, Essani R, Petrone P, Kaiser AM, Asensio J, Beart RW Jr. Management of retained colorectal foreign bodies: predictors of operative intervention. Dis Colon Rectum 2004;47:1694–1698.
17. Saeed A, Johal NS, Aslam A, Brain J, Fitzgerald RJ. Attraction problems following magnet ingestion. Ann R Coll Surg Engl 2009;91:W10–W12.