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Órgano Oficial del Instituto Nacional de Pediatría
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2023, Number 2

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Acta Pediatr Mex 2023; 44 (2)

Gastrojejuncolonic fistula caused by multiple magnets ingestion

Reséndiz-Carbajal CI, Dorado-García I, Rico-Tafoya JR, García-Cabello LM, Vidal-Medina JM
Full text How to cite this article

Language: Spanish
References: 9
Page: 127-130
PDF size: 363.75 Kb.


Key words:

Foreign body, Magnet, fistula, medical emergency.

ABSTRACT

Introduction: Accidental ingestion of magnetic foreign bodies has become more common due to the greater availability of toys with these elements, being a clinical problem between 6 months and 3 years of age, which must be treated promptly since they could cause life-threatening gastrointestinal complications.
Clinical case: A 4-year-old male schoolboy, who presented abdominal pain of 4 days of evolution, colic type, intermittent, without other symptoms; clinically stable, the abdomen without data of peritoneal irritation. An AP and lateral standing X-ray of the abdomen is performed, which shows images of radiopaque foreign bodies (chain of magnets) in the gastric chamber and partial intestinal pneumatization. An endoscopy was performed where 4 spherical magnets embedded in the gastric mucosa that conditioned transmural perforation were visualized. An exploratory laparotomy was performed, finding a perforation in the posterior face of the gastric body that fistulized towards the jejunum and another mirror perforation in the colon, and a chain of 15 circumferential magnets was extracted from the gastric cavity.
Conclusion: The ingestion of magnets must be diagnosed in a timely manner through a directed questioning, based on a simple abdominal X-ray, since this will define the diagnosis and early endoscopic and/or surgical treatment and thus avoid greater gastrointestinal complications secondary to the electromagnetic charge of the magnets, time of ingestion, location and number of foreign bodies.


REFERENCES

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  2. Hernández AE, Gutiérrez SC, Barrios FJ, Ayuso GL, ValdésDE, et al. Intestinal perforation caused by magnetic toys.J Pediatr Surg. 2007; 42: E13-6.

  3. Kramer RE, Lerner DG, Lin T; Manfredi M, Sha M, StephenTC, et al. Management of Ingested Foreign Bodies in Children:A Clinical Report of the NASPGHAN Endoscopy Committee.J Pediatr Gastroenterol Nutr. 2015;60(4): 562-74.

  4. Altokhais T. Magnet Ingestion in Children ManagementGuidelines and Prevention. Front Pediatr. 2021;4:9.

  5. Voulgarelis S, Stucke A. Retrieving multiple magnetic foreignbodies from the glottic entrance and stomach: a casereport. Saudi J Anaesth. 2021;15:56-8

  6. Brown JC, Otjen JP, Drugas GT. Pediatric magnet ingestions:the dark side of the force. Am J Surg. 2014; 207: 754-59.

  7. Martínez CI, Sánchez DP, Herrera N, Ortiz C, Mosquera-Klinger G. Ingestión de múltiples imanes en pediatría:¿emergencia endoscópica o quirúrgica? Rev Gastroenterol,Perú. 2021; 41(1): 33-6.

  8. Han Y, Youn JK, Oh C, Lee S, Seo JM, Kim HY. Ingestion ofmultiple magnets in children. J Pediatr Surg. 2020 Oct;55 (10): 2201-5.

  9. Sola R Jr, Rosenfeld EH, Yu YR, Yangyang R. Yu, St PeterSD, Shah SR. Magnet foreign body ingestion: rare occurrencebut big consequences. J Pediatr Surg. 2018 Sep; 53(9):1815-19.




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Acta Pediatr Mex. 2023;44