Brown Julie C, Murray Karen F, Javid Patrick J
Seattle Children's Hospital and University of Washington, Seattle, Washington 98105, USA.
J Emerg Med. 2012 Aug;43(2):266-9. doi: 10.1016/j.jemermed.2011.09.003. Epub 2012 Jan 12.
Magnet and button battery ingestions are increasingly common, and can result in significant morbidity. Timely identification of hazardous foreign body ingestions can be difficult in non-verbal and non-disclosing children.
We aim to present a case that demonstrates some of the challenges around identifying and correctly locating magnets and batteries, and the importance of prompt identification and removal.
We describe an older child with the covert ingestion of multiple magnets and batteries, with magnets that attracted across the stomach and a loop of jejunum. Mild symptoms and signs resulted in a delayed diagnosis and serious consequences. Radiographs suggested a gastric location of the foreign bodies.
Health care workers should consider the possibility of battery or magnet ingestions in children with vomiting and abdominal pain, even when well-appearing. Like esophageal batteries, multiple gastrointestinal magnets and combined magnet-battery ingestions can cause significant morbidity, and prompt identification is important. Providers should ask verbal children for ingestion histories, and consider radiographs when symptoms are atypical or persistent. Like esophageal batteries, gastrointestinal magnet-battery ingestions should be removed promptly to prevent complications. Caregivers should supervise or limit the use of toys that include magnets and batteries.
吞食磁铁和纽扣电池的情况越来越普遍,可能导致严重的发病情况。对于不会说话和不透露情况的儿童,及时识别危险异物吞食可能很困难。
我们旨在呈现一个案例,展示在识别和正确定位磁铁及电池方面存在的一些挑战,以及及时识别和取出的重要性。
我们描述了一名大龄儿童,他 covert 吞食了多个磁铁和电池,磁铁在胃和一段空肠之间相互吸引。轻微的症状和体征导致诊断延迟并产生了严重后果。X光片显示异物位于胃部。
医护人员应考虑到呕吐和腹痛儿童有吞食电池或磁铁的可能性,即使外表看似正常。与食管电池一样,多个胃肠道磁铁以及磁铁与电池混合吞食都可能导致严重发病情况,及时识别很重要。医疗人员应询问能说话的儿童吞食史,当症状不典型或持续时应考虑进行X光检查。与食管电池一样,胃肠道磁铁与电池混合吞食应及时取出以预防并发症。护理人员应监督或限制使用包含磁铁和电池的玩具。