[Accidental ingestion of two magnets--aggresive or prolonged approach?]

Accidental ingestion of foreign bodies is a common pediatric problem. Non-sharp items like coins, jewelry, pieces of toys are most frequently found among swallowed objects. They usually pass through a child's digestive system without health consequences (40-90% of reported cases). Approximately 10% of children require endoscopic intervention and 1-3% undergoes a surgical treatment. Authors present a unique health hazard caused by multiple magnet ingestion and general management in these cases of this specific foreign body presence. A 6 y.o. boy, in excellent health has been admitted G.I. Dept. presenting a history of accidental ingestion of two magnets (size 1.5 x 0.5 cm) 4 days prior to hospitalization. On admission patient presented no symptoms of foreign body in GI tract, however his WBC was 15000/mm3, ESR-22mm. Foreign bodies have been removed under general anesthesia using endoscopic technique. Endoscopic view of the esophagus region from which magnet has been removed at first might have been identify as a perforation of the esophageal wall. Chest X-ray has not revealed symptoms of pneumothorax, as well as the contrast radiologic study showed symptoms of upper GI tract perforation. Conservative treatment has been administered. Patient has been discharged home with no complaints in general and local good condition. Ingestion of more than one magnets is an strong indication for an immediate endoscopic intervention. Such an algorithm is strongly advocated to prevent of lesion formation in the soft tissues located between two objects with paramagnetic properties which may cause ischemic necrosis and perforation of the GI tract wall.