Department of Medical Imaging, University of Arizona College of Medicine, 1501 N. Campbell Ave, P.O. Box 245067, Tucson, AZ, 85724, USA.
Department of Pediatrics, Tucson Medical Center, 5301 E. Grant Road, Tucson, AZ, 85712, USA.
Emerg Radiol. 2023 Oct;30(5):589-596. doi: 10.1007/s10140-023-02160-7. Epub 2023 Jul 22.
The management of foreign body ingestion proves to be a challenge. Magnets pose a unique set of risks when ingested due to their attractive forces and subsequent risk of adherence, pressure necrosis, and perforation complications. Radiographs only provide a limited snapshot in the setting of multiple magnet ingestion when the risk of complication is highest. We hypothesize that abdominal ultrasound (US) has the potential to supplement radiographs in assessing ingested magnets by determining the presence of bowel loop entrapment and of any extraluminal fluid.
We recreated various scenarios of magnet configurations using animal cadaveric bowel models. X-ray and US images were obtained in various bowel-magnet orientations.
We identified several key US features to suggest bowel wall tethering. These include direct visualization of bowel wall entrapment between magnets (what we term the "dangerous V sign"), anti-dependent positions of the magnets, and inability to separate loops of bowel with compression.
These findings could potentially provide valuable information when directing the urgency of intervention in foreign body ingestion. Ultrasound may supplement and improve the current guidelines in management of magnet ingestion.
异物摄入的管理证明是具有挑战性的。由于磁铁的吸引力及其随后的粘连、压迫性坏死和穿孔并发症的风险，当磁铁被摄入时，它们会带来独特的一系列风险。当并发症风险最高时，对于摄入多个磁铁的情况，射线照片仅提供了有限的瞬间快照。我们假设腹部超声（US）有可能通过确定肠袢嵌顿和任何腔外液体的存在，来补充射线照片评估摄入磁铁的情况。
我们使用动物尸体肠道模型重现了各种磁铁配置的情况。在不同的肠-磁铁方位获取 X 射线和 US 图像。
我们确定了几个关键的 US 特征来提示肠壁束缚。这些特征包括直接观察到磁铁之间的肠壁嵌顿（我们称之为“危险的 V 征”）、磁铁的反依赖性位置以及无法通过压迫分离肠袢。
这些发现可能在外来物体摄入时为指导干预的紧迫性提供有价值的信息。超声可能会补充并改进当前磁铁摄入管理的指南。
