Multidisciplinary management of gastrocolic fistula post ingestion of multiple magnetic beads: a case report
Keywords:Magnetic, Foreign body, Fistula
Foreign body ingestion is quite common in pediatric population, and these cases are usually difficult to manage due to delay in diagnosis. Ingestion of multiple magnetic foreign bodies together is very dangerous and can lead to serious complications like bowel obstruction, fistula and even death. Urgent endoscopic retrieval followed by surgical exploration, if required remains the best approach for removing multiple ingested magnets, thus preventing further injury to the gastrointestinal tract. We report a case of a 2-year-old child who developed a gastrocolic fistula following the ingestion of multiple magnetic beads, which remained undiagnosed weeks after ingestion. Most of the magnetic beads were successfully retrieved endoscopically, however a few remained despite extensive search. Hence the patient underwent emergency laparotomy which showed a gastrocolic fistula, was subsequently repaired after removal of remaining magnetic beads remaining magnetic beads from the colon.
Kramer RE, Lerner DG, Lin T. Management of ingested foreign bodies in children: a clinical report of the NASPGHAN Endoscopy Committee. J Pediatr Gastroenterol Nutr. 2015,60:562-74.
Chen MK, Beierle EA: Gastrointestinal foreign bodies. Pediatr Ann. 2001;30:736-42.
Abbas MI, Oliva-Hemker M, Choi J. Magnet ingestions in children presenting to US Emergency Departments, 2002-2011. J Pediatr Gastroenterol Nutr. 2013;57:18-22.
Oestreich AE. Danger of multiple magnets beyond the stomach in children. J Natl Med Assoc. 2006;98:277-9.
Hernandez AE, Gutierrez SRC, Barrios JE. Intestinal perforation caused by magnetic toys. J Pediatr Surg. 2007;42:13-6.
Tay ET, Weinberg G, Levin TL. Ingested magnets: the force within. Pediatr Emerg Care. 2004;20(13):466-7.
Centers for Disease Control and Prevention (CDC). Gastrointestinal injuries from magnet ingestion in children - United States, 2003-2006. MMWR Morb Mortal Wkly Rep. 2006;55:1296-300.
Waters AM, Teitelbaum DH, Thorne V, Bousvaros A, Noel RA, Beierle EA. Surgical management and morbidity of pediatric magnet ingestions. J Surg Res. 2015;199:137-40.
August A, Mueller C. Early recognition is important when multiple magnets masquerade as a single chain after foreign body ingestion. J Pediatr Surg Case Rep. 2016;13:8-9.
Vijaysadan V, Perez M, Kuo D. Revisiting swallowed troubles: intestinal complications caused by two magnets - a case report, review and proposed revision to the algorithm for the management of foreign body ingestion. J Am Board Fam Med. 2006;19:511-6.
Tsai J, Shaul DB, Sydorak RM, Lau ST, Akmal Y, Rodriguez K: Ingestion of magnetic toys: report of serious complications requiring surgical intervention and a proposed management algorithm. Perm J. 2013;17:11-4.
Phen C, Wilsey A, Swan E, Falconer V, Summers L, Wilsey M. Non-surgical management of gastroduodenal fistula caused by ingested neodymium magnets. Pediatr Gastroenterol Hepatol Nutr. 2018;21:336-40.