Liu Yegen,Li Ganglong,Luo Qiumei,et al.Accidental ingestion of metallic magnetic foreign bodies:a report of six cases with a literature review[J].Journal of Clinical Pediatric Surgery,,21():1185-1190.[doi:10.3760/cma.j.cn101785-202104060-016]
Accidental ingestion of metallic magnetic foreign bodies:a report of six cases with a literature review
- Keywords:
- Foreign Bodies; Metal; Buckeyball; Gastrointestinal Tract; Injuries; Endoscopy; Gastrointestinal; Child
- Abstract:
- Objective To summarize the experiences of treating magnetic metal foreign body in alimentary tract of children.Methods From January 2019 to December 2020,clinical data were retrospectively reviewed for 6 children ingesting magnetic metal foreign bodies.Literature reports related to children ingesting magnetic metal foreign bodies were retrieved from the databases of Wanfang,CNI and PubMed from January 1,2015 to December 31,2020.And clinical characteristics,treatments and outcomes were analyzed.Results The age of onset was (2-6) years and the number of ingested magnetic metal foreign bodies (2-11).Clinical manifestations were non-specific (n=3) and abdominal pain with varying vomiting (n=3).Except for 1 case of excreting through anus,the remainders were surgically removed.Intestinal repair or radical operation of intestinal anastomosis (n=2) and enterostomy plus closed enterostomy (n=2) were performed.In another case,digestive tract remained intact and foreign body was extracted from anus.A total of 10 literatures fulfilling the inclusion criteria were retrieved with a total of 47 children.Four cases swallowed a magnetic metal foreign body and passed it through anus.Three cases swallowed multiple pills at one time.Two cases underwent initial enterostomy and two patients were removed under endoscope.Among 40 cases of multiple ingestion,endoscopic (n=4) and surgical (n=36) extractions were performed.The onset time of 28 cases was recorded.Among 19 cases with onset time >2 days,17 cases were complicated with digestive tract perforation.There were abdominal pain & vomiting (n=35) and non-symptom (n=12).There were negative abdominal signs (n=38),abdominal tenderness (n=7) and abdominal distension (n=2).Among 34 cases complicated with digestive tract perforation,perforation was single (n=5) and multiple (n=29).Among 36 surgical cases,2 cases had no digestive tract perforation and foreign body was removed via an incision of small intestinal wall.The complications were abdominal infection (n=10),partial intestinal necrosis (n=1),intestinal obstruction (n=2) and simple digestive tract fistula (n=25).Among 30 perforated cases of stomach,duodenum and small intestine,intestinal repair or radical enterostomy (n=27) and enterostomy plus stomy closure (n=3) were performed.Four cases of colonic perforation underwent intestinal repair or radical enterostomy.All patients had a decent prognosis.Conclusion Children mistakenly ingesting a single magnetic metal foreign body or multiple magnetic metal foreign bodies at one time may be treated by endoscope.There is a low possibility of multiple magnetic metal foreign bodies to be discharged by anus and timely removal should be performed by endoscope or surgery.A delay of longer than 2 days will elevate the risk of gastrointestinal perforation.For a perforation of stomach,duodenum,small intestine and colon,one-stage repair or anastomosis of intestinal perforation is feasible.Selecting surgical approaches should be based upon operator experiences and the condition of intestinal wall at perforation site.
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Memo
收稿日期:2021-4-25。
通讯作者:吕成超,Email:403105666@qq.com