Naji Hussein, Isacson Daniel, Svensson Jan F, Wester Tomas
Astrid Lindgren Children's Hospital, Karolinska University, Stockholm, Solna, Sweden.
Pediatr Surg Int. 2012 Apr;28(4):367-74. doi: 10.1007/s00383-011-3026-x. Epub 2011 Nov 30.
There are no definite guidelines on the management of ingested magnetic objects in children. The aim of this study was to present our experience and to highlight the importance of strict follow-up.
Within 6 months period, four children presented to the emergency department after ingestion of multiple magnets. We reviewed retrospectively the patients' documents, radiological reports, operative findings and outcome. We also performed a literature search for all reports of multiple magnets ingestion on MEDLINE and EMBASE.
Daily abdominal radiographs to monitor migration of magnetic objects together with clinical examination revealed early detection of perforations in two patients. Explorative laparoscopy and suturing of perforations resulted in a rapid recovery and good cosmetic appearance. Literature search resulted in 44 published articles with a total of 52 cases of multiple magnet ingestion in children.
This report stresses the need for prompt follow-up and early detection of complications in order to operate those patients without delay. Laparoscopy is the method of choice in exploring the abdomen when perforation is suspected.
对于儿童摄入磁性物体的处理,目前尚无明确的指导方针。本研究的目的是介绍我们的经验,并强调严格随访的重要性。
在6个月的时间内,有4名儿童在摄入多个磁铁后前往急诊科就诊。我们回顾性地查阅了患者的病历、放射学报告、手术发现及结果。我们还在MEDLINE和EMBASE上对所有关于多个磁铁摄入的报告进行了文献检索。
每日进行腹部X线检查以监测磁性物体的移动情况,并结合临床检查,使得两名患者的穿孔得以早期发现。探索性腹腔镜检查及穿孔缝合术使患者迅速康复且外观良好。文献检索得到44篇已发表的文章,共52例儿童多个磁铁摄入病例。
本报告强调了及时随访和早期发现并发症以便对这些患者立即进行手术的必要性。当怀疑有穿孔时,腹腔镜检查是探查腹部的首选方法。