Gastrointestinal Perforation Caused by Neodymium Magnet Toys: A Dangerous Foreign Body with Super-Strength

Abstract

Ingestion of neodymium magnets can cause serious complications in children. Making the decision of treatment is difficult because of nonspecific clinical presentation. We report 2 unusual cases of multiple gastrointestinal perforations with closed loop caused by ingestion of multiple bead-shaped neodymium magnets, which are different from the case caused by ingestion of typical magnets. In the first case, the patient was a 2-year-old boy with multiple jejunal perforations. In the second case, the patient was a 19-month-old girl with gastric and proximal jejunal perforations. Patients presented mild and nonspecific symptoms. Exploratory laparotomy was performed, which led to an uneventful postoperative course in both cases. Popular magnet toys composed of small bead-shaped neodymium magnets have different characteristics from typical magnets. They are enough small to swallow easily with greater magnetic force than typical magnets. When multiple neodymium magnets are ingested, they can attract with greater strength across bowel loops, causing pressure necrosis, perforation. However, patients can only present mild and nonspecific symptoms at the time of visit hospital because perforation sites were sealed by magnets which attract each other with great force. Therefore, surgeons should have a high index of suspicion for gastrointestinal perforation in any patient who has ingested multiple magnets, particularly composed of neodymium, presenting with persistent nonspecific abdominal pain.