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Gastrointestinal Perforation Caused by Neodymium Magnet Toys: A Dangerous Foreign Body with Super-Strength

Advances in Pediatric Surgery 2020년 26권 2호 p.83 ~ 87
송금종, 윤종혁, 정해일, 안태성, 손명원, 한선욱, 배상호, 김성용, 백무준, 이문수,
소속 상세정보
송금종 ( Song Geum-Jong ) - Soonchunhyang University Cheonan Hospital Department of Surgery
윤종혁 ( Yun Jong-Hyuk ) - Soonchunhyang University Cheonan Hospital Department of Surgery
정해일 ( Jung Hae-Il ) - Soonchunhyang University Cheonan Hospital Department of Surgery
안태성 ( Ahn Tae-Sung ) - Soonchunhyang University Cheonan Hospital Department of Surgery
손명원 ( Son Myoung-Won ) - Soonchunhyang University Cheonan Hospital Department of Surgery
한선욱 ( Han Sun-Wook ) - Soonchunhyang University Cheonan Hospital Department of Surgery
배상호 ( Bae Sang-Ho ) - Soonchunhyang University Cheonan Hospital Department of Surgery
김성용 ( Kim Sung-Yong ) - Soonchunhyang University Cheonan Hospital Department of Surgery
백무준 ( Baek Moo-Jun ) - Soonchunhyang University Cheonan Hospital Department of Surgery
이문수 ( Lee Moon-Soo ) - Soonchunhyang University Cheonan Hospital Department of Surgery

Abstract


Ingestion of neodymium magnets can cause serious complications in children. Making the decision of treatment is difficult because of nonspecific clinical presentation. We report 2 unusual cases of multiple gastrointestinal perforations with closed loop caused by ingestion of multiple bead-shaped neodymium magnets, which are different from the case caused by ingestion of typical magnets. In the first case, the patient was a 2-year-old boy with multiple jejunal perforations. In the second case, the patient was a 19-month-old girl with gastric and proximal jejunal perforations. Patients presented mild and nonspecific symptoms. Exploratory laparotomy was performed, which led to an uneventful postoperative course in both cases. Popular magnet toys composed of small bead-shaped neodymium magnets have different characteristics from typical magnets. They are enough small to swallow easily with greater magnetic force than typical magnets. When multiple neodymium magnets are ingested, they can attract with greater strength across bowel loops, causing pressure necrosis, perforation. However, patients can only present mild and nonspecific symptoms at the time of visit hospital because perforation sites were sealed by magnets which attract each other with great force. Therefore, surgeons should have a high index of suspicion for gastrointestinal perforation in any patient who has ingested multiple magnets, particularly composed of neodymium, presenting with persistent nonspecific abdominal pain.

키워드

Magnet; Neodymium; Pediatric emergency medicine; Intestinal perforation; Surgery

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