Multiple magnet ingestion causing instestinal obstruction and entero-enteric fistula: Which imaging modality besides radiographs? A case report. (July 2018)

• Record Type: Journal Article
• Authors: Blevrakis, Evangelos; Raissaki, Maria; Xenaki, Sofia; Astyrakaki, Elissavet; Kholcheva, Nelli; Chrysos, Emmanuel
• Is Part Of: Annals of medicine and surgery. Volume 31(2018)
• Page Start: 29
• Page End: 33
• Publication Date: 2018-07
• Subjects: Magnets -- Foreign body ingestion -- Fistula -- Radiograph; AP anterioposterior -- CT Computed Tomography -- FBI Federal Body Investigation -- US Ultra Sonography; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2018.04.033
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Ingested foreign bodies occur in children younger than 3 years and pass uneventfully through the gastrointestinal tract. However, multiple magnet ingestion are associated with serious complications. A 9-year old male with abdominal pain and vomiting 3 days prior to admission, underwent abdominal radiographs showing radiopaque foreign bodies. Ultrasonography (US) independently discovered one magnet floating in the jejunum. Preoperative Computed Tomography (CT) confirmed the presence of two neighbouring magnets causing obstruction and beaking of an adjacent jejunal loop. Laparotomy led to uneventful recovery of transmesenteric fistula formation following pressure necrosis in two jejunal loops. We present the first case of multiple magnet ingestion managed in our institution, where the prevalence of magnet ingestions is low due to unpopularity of magnet toys.Conclusion : Awareness of the potentially devastating effects of multiple magnets passing the pylorus and the contribution of different imaging modalities for the diagnosis are emphasized and discussed. Highlights: What is known Ingested foreign bodies occur in children younger than 3 years and pass uneventfully through the gastrointestinal tract. Multiple magnet ingestion is associated with serious complications. Plain radiographs usually suffice for the diagnosis of multiple magnet ingestion What is new Awareness of the potentially devastating effects of multiple magnets passing the pylorus and the contribution of different imaging modalities for the diagnosis are emphasized and discussed. CT may complement plain radiographs and disclose potential entero-enteric fistulas thereby supporting the indication for surgery.