Experience of treating children with magnets in the gastrointestinal tract

Authors

  • O. O. Losev Odessa National Medical University, Ukraine, Ukraine https://orcid.org/0000-0001-9603-0420
  • M. H. Melnichenko Odessa National Medical University, Ukraine, Ukraine https://orcid.org/0000-0001-9066-4801
  • I. R. Dilanyan Municipal Institution «Odessa Regional Children's Clinical Hospital», Ukraine, Ukraine https://orcid.org/0000-0002-3002-0438
  • K. O. Loseva Odessa National Medical University, Ukraine, Ukraine
  • V. V. Antonyuk Municipal Institution «Odessa Regional Children's Clinical Hospital», Ukraine, Ukraine https://orcid.org/0000-0001-8755-8872
  • L. P. Matviichuk Municipal Institution «Odessa Regional Children's Clinical Hospital», Ukraine, Ukraine
  • S. V. Pravosudov Municipal Institution «Odessa Regional Children's Clinical Hospital», Ukraine, Ukraine
  • O. S. Pravosudov Municipal Institution «Odessa Regional Children's Clinical Hospital», Ukraine, Ukraine
  • I. S. Belystov Municipal Institution «Odessa Regional Children's Clinical Hospital», Ukraine, Ukraine
  • L. P. Tkachenko Municipal Institution «Odessa Regional Children's Clinical Hospital», Ukraine, Ukraine
  • N. R. Gavrilyshen Municipal Institution «Odessa Regional Children's Clinical Hospital», Ukraine, Ukraine

DOI:

https://doi.org/10.15574/PS.2018.60.56

Keywords:

children, neodymium magnets, gastrointestinal tract

Abstract

Introduction. The probability of neodymium magnets ingestion in the gastrointestinal tract (GIT) by children is very high, however, there is still no unified treatment algorithm of their removal: some authors recommend to wait, while others insist on immediate endoscopic removal or surgery.

Objective: management improvement of treating children with magnets in the gastrointestinal tract.

Material and methods. There were 7 children with magnets in their GIT followed-up. All children underwent complete general clinical and instrumental examination (abdominal ultrasound, abdominal X-ray).

Results. The examination revealed gastric location of magnets in 3 (42.9%) children: in 1 case, it was passed in the stool, in 1 case – removed using EGDS, and 1 case required a gastrotomy. In the rest 4 (57.1%) children magnets were detected in the intestine, and laparotomy was performed for peritonitis and intestinal obstruction. Six children (85.7%) were recovered. Based on the results of case study, a treatment algorithm is developed for the suspected swallowed magnets of GIT.

Conclusions. At suspicion on neodymium magnets ingestion, one must not waiting it to traverse the gastrointestinal tract and pass in the stool spontaneously. An anamnesis should be carefully taking as well as abdominal X-ray and abdominal ultrasound must be conducted. Further medical tactics depends on the number of magnets and time lapse since ingestion: the more magnets are swallowed, the faster laparotomy should be performed.

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Issue

Section

Original articles. Abdominal surgery