Kakiuchi Toshihiko, Nosho Tetsuya
Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan.
Case Rep Pediatr. 2023 Mar 1;2023:1512514. doi: 10.1155/2023/1512514. eCollection 2023.
Foreign body ingestion is one of the common problems among children. A three-year-old girl presented to the emergency department 2 h after ingesting three small disk-type neodymium magnets. She had no gastrointestinal symptoms. Abdominal radiography revealed a foreign body in the left upper quadrant, which was the three circular magnets. Fluoroscopy was performed. She was placed in the right lateral decubitus position for 3 min and slowly returned to the supine position. Abdominal fluoroscopy revealed a foreign body migrating near the middle of the spine. Similarly, when she was placed in the left lateral decubitus position for 3 min and slowly returned to the supine position, the foreign body migrated to the outermost part of her left upper quadrant. Thus, we anticipated that the magnets could be excreted spontaneously. The patient did not develop any gastrointestinal symptoms after returning home, and two days later, three overlapping magnets were finally found in her stool. During accidental ingestion of single or multiple desk-type neodymium magnets, endoscopic removal may not be necessary if they are mobile and clump together in the stomach. Regarding the ingestion of multiple desk-type neodymium magnets, fluoroscopy is useful to determine the extent of endoscopic intervention.
吞食异物是儿童常见问题之一。一名三岁女孩在吞食三块小型圆盘状钕磁铁两小时后被送往急诊科。她没有胃肠道症状。腹部X线检查显示左上腹有一异物,即三块圆形磁铁。进行了荧光透视检查。她被置于右侧卧位3分钟,然后缓慢恢复仰卧位。腹部荧光透视显示异物向脊柱中部附近移动。同样,当她被置于左侧卧位3分钟并缓慢恢复仰卧位时,异物移至左上腹最外侧。因此,我们预计磁铁可能会自行排出。患者回家后未出现任何胃肠道症状,两天后,最终在她的粪便中发现了三块重叠的磁铁。在意外吞食单个或多个台式钕磁铁时,如果它们在胃中可移动并聚集在一起,则可能无需进行内镜取出。对于吞食多个台式钕磁铁的情况,荧光透视有助于确定内镜干预的程度。