K. Gerlach, Dirk Schaper (Klinik für Kinderchirurgie Krankenhaus St. Elisabeth und St. Barbara Halle/S.)  

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11 Years  

Male  

Abdomen-Other and unknown  

physical  

Recurrent intermittend abdominal pain and vomiting for about 1 week. Last bowel movement yesterday - unremarkable. No dysuria. Subfebrile temperature.
Reduced general appearance, very slim body.
Abdomen distended, diffuse tenderness, palpable resistance in the right mid- and lower abdomen with mild guarding. Few peristalsis in all four quadrants.

Lab work: Hb 9,25 mmol/l; Hk 0,430; WBC 14, 3Gpt/l; PLT 424 Gpt/l, CRP 22,09 mg/l;
Electrolytes, ASAT, ALAT, GGT, Lipase WNL, Amylase 24,5 U/l; BS 6,63 mmol/l;
Crea 52 g/l; ESR 8 mm/h.  

Magnetic forces act throughout the bowel wall and lead to compression related damage, dysmotility and kinking. Severe injuries and damages of the small bowel, including ischemia, peritonitis and even a case report about death have been described.  

<- view Ultrasound 1

Ultrasound 1: Echogenic foreign body.




<- view Ultrasound 2

Ultrasound 2: Echogenic, segmented foreign body.




<- view OP-Situs 1

OP-Situs 1: Introperative findings of a small bowel perforation.



<- view OP-Situs 2

OP-Situs 2: Foreign body intraoperative



<- view OP-Situs 3

OP-Situs 3: Foreign body in situ



<- view X-Ray 1

X-Ray 1: KUB: Tablet / rod like metallic foreign body in the right lower abdomen.



 

Surgery / Histo  

Other radiopaque ingested foreign bodies.  

Laparotomy: Removal of 14 magnets with a total of 9 small bowel perforations, 1 ileocecal fistula, and 2 perforations in the region of the mesenterium commune.

Intestinal tube splinting, drainage, NG tube
Retraction of the intestinal tube splinting at POD (post operative day) 5, removal at POD 9, start diet.  

Magnets are more frequently seen in nurseries and playrooms due to the arise of new toy variants. The development of extrem strong magnets by the industry brings also new, partly unknown sources of danger to the children. The so called Neodym magnets have an extrem strong force of gravity, which can even cause contusions of fingers. One can easily imagine that ingestion of such kind of magnets may cause rapidly damage to the bowel wall. The magnets attract each other and always try to unite, where the bowel wall does not present an obsticle.  

Injuries due to magnets are known for a longer time in Japan, because magnets are commonly used for muscle relaxation therapy. Severe injuries of the small bowel, including ischemia, peritonitis and death have been described.  

N/A  

Ileus, obstructive ileus, mechanic ileus, foreign body, foreign body ingestion, foreign bodies, magnets, metallic rods, metal ingestion, magnet, child, childhood, pediatric radiology  

K Gerlach, Dirk Schaper. Bowel perforation and ileus after ingestion of magnets. PedRad [serial online] vol 6, no. 9.
URL: www.PedRad.info/?search=20060928135619