Gün Feryal, Günendi Tansel, Kılıç Başak, Celik Alaaddin
Department of Pediatric Surgery, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey.
Ulus Travma Acil Cerrahi Derg. 2013 Mar;19(2):177-9. doi: 10.5505/tjtes.2013.26779.
Foreign body ingestion is a common clinical situation that is primarily diagnosed by emergency clinicians. Most foreign bodies can be evacuated without difficulty. Although rare, magnets that reach the lower intestinal tract may cause complications such as intestinal fistula formation, perforation, volvulus or appendicitis. We report herein a two-year-old girl who was admitted to our department 3 days ago with abdominal pain and non-bilious vomiting. Upon admission direct abdominal roentgenogram revealed a foreign body consisting of multiple spheric parts bound together forming a circle in the lower quadrants of the abdomen. Her family, unaware of this ingestion, stated that a magnetic toy matching the object present on the plain radiograph was lost several days ago. Surgical intervention showed a magnetic toy in the proximal part of the ileum causing multiple perforations in the intestinal wall and the neighboring mesentery. The ileal portion containing the magnet toy was seen folded over itself forming a blind loop. The patient was discharged uneventfully in the 7th postoperative day. Our case highlights a well known fact that foreign body ingestion in children may not have eye witnesses and should be taken into consideration when evaluating children with abdominal pain.
异物摄入是一种常见的临床情况，主要由急诊医生进行诊断。大多数异物可顺利排出。尽管罕见，但进入下消化道的磁铁可能会导致诸如肠瘘形成、穿孔、肠扭转或阑尾炎等并发症。我们在此报告一名两岁女童，她于3天前因腹痛和非胆汁性呕吐入院。入院时腹部X线平片显示一个异物，由多个球形部分结合在一起，在腹部下象限形成一个圆圈。她的家人不知道有异物摄入情况，称几天前丢失了一个与X线平片上显示的物体相符的磁性玩具。手术干预发现一个磁性玩具位于回肠近端，导致肠壁和相邻肠系膜多处穿孔。可见含有磁性玩具的回肠部分自身折叠形成一个盲袢。患者术后第7天顺利出院。我们的病例凸显了一个众所周知的事实，即儿童异物摄入可能没有目击者，在评估腹痛儿童时应予以考虑。
