Cevizci Mehmet Nuri, Karadağ Cetin Ali, Demir Mesut, Dokucu Ali Ihsan
Sigli Etfal Eğitim ve Araştirma Hastanesi, Cocuk Cerrahisi Kliniği, Istanbul, Turkey.
Ulus Travma Acil Cerrahi Derg. 2012 Mar;18(2):192-4. doi: 10.5505/tjtes.2012.22457.
Multiple magnet ingestion during childhood may result in emergency situations. A single magnet may be discharged with intestinal peristalsis, but multiple magnets may stick together and cause significant intestinal complications. Here we present a case with intestinal perforation due to ingestion of multiple magnets and metal pieces. An eight-year-old girl presented with abdominal pain and vomiting. She had abdominal tenderness and defense on the physical examination. Abdominal X-ray showed air and fluid levels. Metallic images were not considered at first as important in the diagnosis. Abdominal ultrasonography was reported as acute appendicitis. During the abdominal exploration, the appendix was normal, but there were dense adherences around the ileum and cecum. After adhesiolysis, intestinal perforations were seen in the cecum and 15 and 45 cm proximal to the cecum. Magnet and metal pieces were present in the perforated segments. Wedge resection and primary repair was performed. There were no postoperative complications, and she was discharged on the postoperative fifth day. Pediatric surgeons should be aware of the complications of multiple magnet ingestion. If the patient has a history of multiple magnet ingestion, follow-up with daily abdominal X-rays should be done, and in cases where magnets seem to cluster together or if acute abdominal signs develop, surgical exploration should be considered.
儿童期吞食多枚磁铁可能导致紧急情况。单枚磁铁可能随肠道蠕动排出，但多枚磁铁可能相互粘连并引发严重的肠道并发症。在此，我们报告一例因吞食多枚磁铁和金属片导致肠穿孔的病例。一名8岁女孩出现腹痛和呕吐症状。体格检查发现腹部压痛及反跳痛。腹部X线显示气液平面。起初，金属影像在诊断中未被视为重要因素。腹部超声报告为急性阑尾炎。在腹部探查过程中，阑尾正常，但回肠和盲肠周围有致密粘连。粘连松解后，在盲肠及距盲肠近端15厘米和45厘米处可见肠穿孔。穿孔部位有磁铁和金属片。进行了楔形切除和一期修复。术后无并发症，术后第5天出院。小儿外科医生应了解吞食多枚磁铁的并发症。如果患者有吞食多枚磁铁的病史，应每日进行腹部X线随访，若磁铁似乎聚集在一起或出现急腹症体征，则应考虑手术探查。
