Department of Pediatric Surgery, Zeynep Kamil Maternal and Child Diseases Educational and Research Hospital, Department of Pediatric Surgery, Istanbul, Turkey.
World J Pediatr. 2010 Nov;6(4):369-71. doi: 10.1007/s12519-010-0237-5. Epub 2010 Nov 16.
Ingestion of foreign objects is a common problem in children. Ingestion of one more magnets may require surgical intervention because of risk of perforation.
A 4-year-old girl was admitted to our department with complaints of abdominal pain and bilious vomiting. She had been treated at another clinic with repeated abdominal X-rays because of ingestion of a magnet 5 days ago. Physical examination revealed diffuse abdominal tenderness and bilious drainage from the nasogastric tube. The magnet was observed by radiopaque imaging in the right epigastric region of the upright abdomen but there was no free air. The magnet was presumed to be in the duodenum and exploratory laparotomy was performed.
During the operation, a perforation was found between the pylorus and duodenum due to the magnet. The foreign body was found to be two magnets adherent to each; the interposed and compressed tissue was necrotized and perforated between the two magnets. The necrotized segment was excised and primary anastomosis was made. The postoperative period of the patient was uneventful and she was discharged on the seventh postoperative day.
Ingestion of foreign objects such as one more magnets may cause intestinal perforation in early stages. If the object stays in the same location shown by repeated X-rays, surgical intervention should not be delayed.
吞食异物是儿童常见的问题。吞食一个以上的磁铁可能需要手术干预，因为有穿孔的风险。
一名 4 岁女孩因腹痛和胆汁性呕吐到我院就诊。她因 5 天前吞食磁铁曾在另一家诊所接受过多次腹部 X 光检查。体格检查显示全腹弥漫性压痛，鼻胃管中有胆汁流出。立位腹部 X 线片显示在上腹部右侧可见磁铁显影，但无游离气体。推测磁铁在十二指肠内，行剖腹探查术。
术中发现因磁铁导致幽门和十二指肠之间穿孔。发现异物是两个相互粘连的磁铁；两个磁铁之间的中间和受压组织坏死穿孔。坏死段被切除并进行了一期吻合。患者术后恢复顺利，术后第 7 天出院。
吞食异物（如一个以上的磁铁）可能会导致早期肠道穿孔。如果物体在重复 X 光片上显示的同一位置停留，不应延迟手术干预。
