A fleet of 24 magnets were removed successfully from a 2 years old patient by combined endoscopy and laparotomy. The child had ingested unaccounted number of magnetic spheres 3 months back and went unnoticed. He presented to our ER with abdominal pain & poor feeding and the gastroenterology team (Dr Mustafa) diagnosed the case to be of neglected foreign body ingestion with complications. Upper GI endoscopy was done , 8 magnetic spheres removed from stomach and a GE junction polyp was excised. Since majority of residual magnets had migrated extramurally, exploratory laparotomy was done. It revealed two duodeno-jejunal fistulae from 2nd and 4th part , three jejujo –jejunal fistulae and one complex jejuno-jejunal-ileal fistula containing magnetic bodies. Multiple duodenotomies, and enterotomies done to retrieve the magnets. One magnet had penetrated the pancreas and was retrieved with pancreatic repair. The child is recovering well in the pediatric ward after a brief observation in the PICU. Family is extremely grateful for the efficient management of this highly complex complication of seemingly innocuous ingestion of magnetic toy.
We humbly urge our colleagues to spread the awareness among the parents and around the community to discourage giving this newly introduced magnetic bead toy to children especially below 3 years old . Dr Mustafa had encountered two such cases in the recent weeks requiring interventions.
A huge note of appreciation goes to Dr Mustafa and the Endoscopy team, ED team, OR nurses(Leo, Reshma & Sheena) , anaesthetists ( Dr. Dhia and Dr. Ram) and technicians, PICU team and pediatric ward nurses for their best efforts and care.