Author Affiliations: Department of  Pediatric Surgery, Zeynep Kamil Maternal and Child Diseases Educational and Research Hospital, Department of Pediatric Surgery, Istanbul, Turkey (Sahin C, Alver D, Gulcin N, Kurt G, Celayir AC)

Corresponding Author: Aysenur Cerrah Celayir, Pediatric Surgery, and Director of Hospital, Zeynep Kamil Kadin ve Cocuk Hastaliklari Egitim ve Arastirma Hastanesi, Bashekim Arakiyeci Haci Mehmet Mah. Op.Dr.Burhanettin Ustunel Cad. No:10, 34668, Uskudar, Istanbul, Turkey (Tel: + 90 216 343 20 73; Fax: + 90 216 343 92 51; Email: celayiraysenur@gmail.com)

Background: Ingestion of foreign objects is a common problem in children. Ingestion of one more magnets may require surgical intervention because of risk of perforation.

Methods: A 4-year-old girl was admitted to our department with complaints of abdominal pain and bilious vomiting. She had been treated at another clinic with repeated abdominal X-rays because of ingestion of a magnet 5 days ago. Physical examination revealed diffuse abdominal tenderness and bilious drainage from the nasogastric tube. The magnet was observed by radiopaque imaging in the right epigastric region of the upright abdomen but there was no free air. The magnet was presumed to be in the duodenum and exploratory laparotomy was performed.

Results: During the operation, a perforation was found between the pylorus and duodenum due to the magnet. The foreign body was found to be two magnets adherent to each; the interposed and compressed tissue was necrotized and perforated between the two magnets. The necrotized segment was excised and primary anastomosis was made. The postoperative period of the patient was uneventful and she was discharged on the seventh postoperative day.

Conclusions: Ingestion of foreign objects such as one more magnets may cause intestinal perforation in early stages. If the object stays in the same location shown by repeated X-rays, surgical intervention should not be delayed.

Key words: foreign body; intestinal perforation; magnet ingestion

World J Pediatr 2010;6(4):369-371