Introduction: Magnetic beads are hazardous, having potentially lethal consequences if ingested.
Case Report: A two-year-old girl, presented to the pediatric emergency department with an history of worsening abdominal pain, nausea and vomiting. The patient appeared in moderate distress. Physical examination revealed abdominal tenderness with guarding and rigidity. On abdominal X-ray examination, nine opaque foreign bodies (magnetic beads) were seen in the left hypochondrium. Explorative gastroscopy was performed and two magnets appeared at the lessure curvature, but not the reaming seven. These were pulled out and another gastroscopic attempt showed appearance of another two of the remaining ones. Removing these, the remaining five were all attached as seen on the X-ray. The magnets must have caused pressure necrosis on a gastric mucosa fold with subsequent limited submucosal perforation making a pouch was the spheres were logged.
Conclusion: The ingestion of multiple magnets may require urgent surgical intervention and early removal because of very high risk of gastrointestinal perforation.

Keywords: Children, Ingestion, Magnetic beads, Perforation

Accidental ingestion of foreign bodies is a common problem in children [1][2]. The majority of ingested foreign bodies pass spontaneously without treatment. Magnetic beads are hazardous, having potentially lethal consequences if ingested [3] [4][5][6].

A two-year-old girl, weight 19 kg presented to the pediatric emergency department with an eight hour history of worsening abdominal pain, nausea and alimentary vomiting. The patient appeared pale with dry mucous membranes and in moderate distress. Vitals signs were as follows: temperature 36.7°C, heart rate 156 bpm, SPO2 100%, respiratory rate 26 rpm, blood pressure 90/72 mmHg. Physical examination revealed abdominal tenderness with guarding and rigidity. The intravenous infusion of crystalloid fluids was started in pediatric emergency department.

On abdominal X-ray examination, there was no free air or dilated bowel loops; however, nine opaque foreign bodies (magnetic beads) were seen in the left hypochondrium (Figure 1A). Explorative gastroscopy was performed and two hypochondrium (Figure 1B), but not the remaining seven. These were pulled out and another gastroscopic attempt showed appearance of another two of the remaining ones. Removing these, the remaining five were all attached as seen on the X-ray (Figure 1C). Gastric perforation was suspected. Laparoscopic assisted enterolysis from the Treitz to terminal ileum was performed and no perforation was seen. Stomach anterior wall was free of any perforations. The magnets must have caused pressure necrosis on a gastric mucosa fold with subsequent limited submucosal perforation making a pouch were the spheres were logged (Figure 1D). The postoperative period was uneventful and the patient was discharged on the second postoperative day.

Complications from foreign body ingestion in children are uncommon but the ingestion of multiple magnets may require urgent surgical intervention and early removal because of very high risk of gastrointestinal perforation [1][2][3].

Prevention campaigns from health authorities should start about the hazards of magnetic toys to prevent the appearance of new similar cases.

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