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confirmed the magnets' position in the distal ileum or cecum. During colonoscopy and ileoscopy, no magnets were visualized. On careful withdrawal of the scope, the 4 magnets were seen attracted to one another in the rectum. The magnets were then removed with a Roth net. An 11-year-old male accidentally swallowed 2 buckyball magnets. The 2 attracted magnets moved to the right lower quadrant on X ray where they remained for 54 hours. During colonoscopy, no magnets were visualized in the cecum. However, during an attempt at ileoscopy, the connected magnets appeared in the cecum and the magnets were then moved with a Roth net. (Figure ) Discussion: For these patients, the magnets were not visualized initially during colonoscopy. It is our theory that due to their powerful magnetic force, the magnets were attracted to the magnetic insertion tube, proximal to the non-magnetic bending section of the scope and approximately 15 cm from the lens. Therefore, the endoscopist was not able to visualize the magnets until they were physically separated from the insertion tube. Endoscopists should be aware that the magnets may adhere to the insertion tube, which is not in the field of vision and can lead to confusion during colonoscopy. When considering this possibility, we recommend retroflexion of the bending segment if in an approximate location of the magnets per imaging. Additionally, we recommend re-examining the rectum as the magnets may disconnect from the scope as the insertion tube is withdrawn past the anal sphincter, leaving the magnets behind in the rectum to be visualized by the non-magnetic lens and bending section.

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