An intestinal fistula in a 3-year-old child caused by the ingestion of magnets: Report of a case

Abstract

We describe herein the case of a 3-year-old child in whom a jejunoileal fistula was caused by the ingestion of magnets. This case report demonstrates that if more than one magnet is found as a foreign body in the intestine, they should not be left untreated even if there are no sharp edges and, it seems they could be evacuated spontaneously. This recommendation is made because the magnets will attract each other and hold the intestinal walls between them, causing necrosis and resulting in intestinal perforation or a fistula.

Perils in the playpen: Duodenojejunal fistula in a child following ingestion of two toy magnets

“…MRI of the abdomen should never be used as it can precipitate a perforation 1 . Modern NIB (alloy of Neodymium, Iron and Boron 7 ) toy magnets are 10 times more powerful than traditional magnets 8 capable of producing attractive forces up to 1300 G. 9 These have been known to erode through the intervening bowel wall resulting in perforation, internal enteric fistulae, internal herniation, adhesions, volvulus, obstruction 2 , mesenteric hemorrhage 4 and death 3 . Enteric fistulae reported are jejunoileal, jejuno-caecal, jejuno-colic and ileo-ileal.…”

Revisiting Swallowed Troubles: Intestinal Complications Caused by Two Magnets--A Case Report, Review and Proposed Revision to the Algorithm for the Management of Foreign Body Ingestion

“…31 Our review of the literature indicates a report in Japanese as early as 1991 in Shonika (Pediatrics of Japan). These case reports are from Japan 2 and Korea 3 where magnets are used for treatment of stiffness of neck or shoulders, improvement of circulation. These magnets are small enough to be swallowed easily and can cause problems more if than one is swallowed.…”

“…A few cases of intestinal obstruction due to magnet ingestion have been reported in Japan, China, and Korea where magnets are used for treatment in traditional medicine. [1][2][3][4][5] When more than one magnet is ingested they can be attracted to each other through the intestinal wall, causing necrosis and intestinal perforation or fistula, so they should be removed while they are still accessible with endoscope.…”

The risks of gastrointestinal injury due to ingested magnetic beads

“…Since 1995, there have been an increasing number of reports on the consequences of toy magnet ingestion. [1] One ingested magnet should not cause any problems, but when multiple individual magnets are ingested, they can cause considerable morbidity. [2] This occurs when magnets conglomerate in different segments of bowel with forces of up to 1 300 G, [1] causing pressure necrosis, perforation and/or fistula formation anywhere along the GIT.…”

“…[1] One ingested magnet should not cause any problems, but when multiple individual magnets are ingested, they can cause considerable morbidity. [2] This occurs when magnets conglomerate in different segments of bowel with forces of up to 1 300 G, [1] causing pressure necrosis, perforation and/or fistula formation anywhere along the GIT. [3] Other reported magnet-induced problems include ulceration, [4] gastric outlet or bowel obstruction, [5] oesophageal perforation, [6] gastro-enteric fistulas, [7] small-bowel volvulus, [8] and appendicitis due to ileocaecal fistulation.…”