Laparoscopic diagnosis of magnetic malrotation with fistula and volvulus
Kimberly E Wooten1, Charles W Hartin, Doruk E Ozgediz
1Department of Surgery, State University of New York, Buffalo, NY, USA. kewooten@buffalo.edu
Introduction:
Most foreign bodies that a child ingests pass harmlessly through the gastrointestinal tract. However, ingesting multiple magnets places a child at risk for serious viscus injury.
Case Description:
A 16-y-old boy swallowed multiple magnets and presented with abdominal pain and emesis. Upon laparoscopy, the boy was found to have malrotation with volvulus caused by a cecal magnet attracted to a gastric magnet, resulting in a gastrocecal fistula.
Discussion:
We review the management of magnet ingestion with an emphasis on a high index of suspicion and the use of laparoscopy for diagnosis, as well as the consequences of a coexisting rotational anomaly.
Insights
Ingesting multiple magnets can cause serious gastrointestinal injury in children, leading to complications like fistulas. Early diagnosis with laparoscopy is crucial for managing these cases, especially with underlying malrotation.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Medical Imaging
Background:
- Most ingested foreign bodies pass harmlessly.
- Ingesting multiple magnets poses a significant risk for severe gastrointestinal injury in children.
Purpose of the Study:
- To review the management of pediatric magnet ingestion.
- To highlight the importance of a high index of suspicion and diagnostic laparoscopy.
- To discuss complications, including those associated with coexisting intestinal malrotation.
Main Methods:
- Case report of a 16-year-old male with abdominal pain and emesis after swallowing multiple magnets.
- Diagnostic laparoscopy revealed malrotation with volvulus and a gastrocecal fistula.
- Literature review on the management of magnet ingestion.
Main Results:
- A gastrocecal fistula was identified, caused by magnetic attraction between a gastric and a cecal magnet.
- The patient presented with symptoms of bowel obstruction and malrotation.
Conclusions:
- Magnet ingestion in children requires a high index of suspicion for serious viscus injury.
- Laparoscopy is a valuable diagnostic and therapeutic tool.
- Coexisting intestinal malrotation can complicate magnet ingestion cases, leading to conditions like volvulus and fistulas.
