Magnet ingestion in children: a case series

Introduction

Multiple magnet ingestion constitutes an ever-present problem in pediatric surgery. Magnets, attracted to each other, can cause intestinal wall compression, perforation, and eventually, fistulation.

Case presentation

Case 1: A nine-year-old female was admitted after swallowing magnetic beads six days prior. More than 20 magnetic balls were seen on an X-ray. She remained asymptomatic during the three days of observation and passed the magnetic beads spontaneously.

Case 2

A sixteen-month-old female was admitted 6 h after swallowing magnetic objects. An X-ray performed on admission showed four adherent magnetic beads. The patient was observed for seven days, during which she remained asymptomatic. Due to the lack of magnetic bead progression, the patient underwent surgery on the eighth day. Intraoperatively, an enteroenteric fistula was found, and a wedge resection of the intestine was performed. The patient was discharged home a week after surgery.

Case 3

A two-year-old female was admitted to the Pediatric Ward on suspicion of viral gastroenteritis. The patient deteriorated and developed symptoms of shock. An X-ray was performed, revealing ileus and five adherent magnetic beads. The patient underwent surgery. Intraoperatively, an enteroenteric fistula was found, with magnetic beads passing through the mesentery. A wedge resection of the intestine was performed, and the mesenteric perforation was closed. The patient was discharged home a week after surgery.

Conclusion

Children who ingest multiple magnets can have a wide range of clinical presentations. A trial of watchful observation is accepted in asymptomatic patients. Magnets that do not progress should be surgically removed.