Ke Mengyu, Yang Jun
School of Medicine, Jianghan University, Wuhan, China.
Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.
Front Surg. 2025 Aug 7;12:1583175. doi: 10.3389/fsurg.2025.1583175. eCollection 2025.
Children frequently swallow foreign objects, and ingesting magnets on occasion can cause major problems because they are composed of unique materials that draw to one another in the intestinal wall. As a result, there is a significant chance of intestinal wall necrosis, intestinal perforation, and fistula formation. On the basis of the history of magnet ingestion, clinical signs like nausea and vomiting, and x-ray imaging, it is easy to diagnose magnet-induced complications. However, there was no foreign body shadow in the x-ray, and some intermittent swallowing of magnets in different intestinal tubes attracted one another, causing intestinal perforation and subsequent discharge along with the feces.
We describe the case of an 8-year-old girl who had been consuming two magnets for six days when she arrived at our hospital's emergency room with sporadic stomach ache and vomiting for two days. The youngster had a history of vomiting yellow-green bile, and a physical examination revealed a noticeable intestinal pattern with noticeable periumbilical discomfort. An abdominopelvic CT scan indicated intestinal obstruction, while an abdominal x-ray indicated minimal distension of the intestinal tube and a fluid level. No obvious foreign body shadow was seen in the abdominal cavity. Laparoscopic exploration revealed two perforations, one in the colon and one in the small bowel; no magnets were found intraoperatively. Intraoperative abdominal radiographs suggested loss of signs of limited intestinal distension and no foreign body was seen. Considering the absence of foreign bodies observed during the operation and the patency of the intestine postoperatively, it is reasonably inferred that the magnet was excreted via feces after causing intestinal perforation. The patient's condition was stable after the operation and she was discharged from the hospital after 9 days.
This case emphasizes the necessity of maintaining clinical vigilance in pediatric patients with suspected magnet ingestion, even when imaging fails to identify foreign bodies. Notably, the absence of intraoperatively retrieved magnets does not preclude magnet-induced injuries, and early surgical exploration may contribute to improved clinical outcomes.
儿童经常吞食异物，偶尔摄入磁铁会引发重大问题，因为它们由特殊材料制成，在肠壁内会相互吸引。因此，肠壁坏死、肠穿孔和瘘管形成的可能性很大。根据吞食磁铁的病史、恶心和呕吐等临床症状以及X光成像，很容易诊断出磁铁引起的并发症。然而，X光检查未发现异物阴影，且不同肠段内间歇性吞食的一些磁铁相互吸引，导致肠穿孔并随后随粪便排出。
我们描述了一名8岁女孩的病例，她吞食两块磁铁六天后，因间歇性胃痛和呕吐两天来到我院急诊室。该患儿有呕吐黄绿色胆汁的病史，体格检查发现明显的肠型，脐周压痛明显。腹部盆腔CT扫描显示肠梗阻，腹部X光显示肠管轻度扩张并有液平面。腹腔内未发现明显异物阴影。腹腔镜探查发现两个穿孔，一个在结肠，一个在小肠；术中未发现磁铁。术中腹部X光片显示肠管局限性扩张体征消失，未发现异物。考虑到手术中未观察到异物且术后肠道通畅，合理推断磁铁在导致肠穿孔后经粪便排出。患者术后病情稳定，9天后出院。
本病例强调了对疑似吞食磁铁的儿科患者保持临床警惕的必要性，即使影像学检查未能发现异物。值得注意的是，术中未取出磁铁并不排除磁铁引起的损伤，早期手术探查可能有助于改善临床结局。
