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    Go to the top of the page   ID: 20060928135619 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Bowel perforation and ileus after ingestion of magnets
    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


     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] There are Ultrasound-images available for this case. [ Ultrasound ] There are OP-Situs-images available for this case. [ OP-Situs ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

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

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    11 Years  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    Abdomen-Other and unknown  

     
     Pediatric Radiology CasesMost likely etiology:

    physical  

     
     Pediatric Radiology CasesHistory:

    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.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    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.  

     
     Pediatric Radiology CasesRadiological findings:


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Echogenic foreign body.




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Echogenic, segmented foreign body.




    OP-Situs 1 <- view OP-Situs 1

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



    OP-Situs 2 <- view OP-Situs 2

    OP-Situs 2: Foreign body intraoperative



    OP-Situs 3 <- view OP-Situs 3

    OP-Situs 3: Foreign body in situ



    X-Ray 1 <- view X-Ray 1

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



     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Surgery / Histo  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Other radiopaque ingested foreign bodies.  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    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.  

     
     Pediatric Radiology CasesComments of the author about the case:

    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.  

     
     Pediatric Radiology CasesFirst description / History:

    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.  

     
     Pediatric Radiology CasesLiterature:

    N/A  

     
     Pediatric Radiology CasesKeywords:

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

     
     Pediatric Radiology Cases Cite this article:

    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  

     
     Pediatric Radiology Cases Read similar articles: with corresponding keywords
    in the same field: Abdomen-Other and unknown
    or in the region: Abdomen
    or in the tissue/organ: Other and unknown
    or with the etiology: physical
     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] There are Ultrasound-images available for this case. [ Ultrasound ] There are OP-Situs-images available for this case. [ OP-Situs ] View all modalities [ All ]   
     
    Bowel perforation and ileus after ingestion of magnets
    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


     

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    Bowel perforation and ileus after ingestion of magnets
    Other cases by these authors:

    Search K. Gerlach in Medline K. Gerlach (5)   
    Search Dirk Schaper  in Medline Dirk Schaper (15)   

    Bowel perforation and ileus after ingestion of magnets  
     
    Bowel perforation and ileus after ingestion of magnets
    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


     

    Which diagnosis have other collegues guessed?


    • Ingestion of batteries
      Votes: 4 (17 %)


    • Residual metallic tube after prior endoscopic laparatomy (appendectomy at the age of 9)
      Votes: 2 (8 %)


    • Bowel perforation and ileus secondary to ingestion of magnets
      Votes: 17 (73 %)


    • Foreign body on film in case of a salmonella induced enteritis
      Votes: 0 (0 %)



        Total answers: 23

     
    Bowel perforation and ileus after ingestion of magnets
    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


     

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    Bowel perforation and ileus after ingestion of magnets
    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


     




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