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Gastric Perforation During MRI After Ingestion of Ferromagnetic Foreign Bodies

Nicholas M Glover1, Ryan Roten1

  • 1Desert Regional Medical Center, Department of Emergency Medicine, Palm Springs, California.

Clinical Practice and Cases in Emergency Medicine
|August 26, 2021
PubMed
Abstract

Insights

Ingesting ferromagnetic foreign bodies before magnetic resonance imaging (MRI) can lead to severe complications, including gastric perforation and shock. This case underscores the critical risks associated with MRI in patients with undisclosed or surreptitiously ingested metallic objects.

Area of Science:

  • Medical Imaging Safety
  • Gastroenterology
  • Emergency Medicine

Background:

  • Magnetic Resonance Imaging (MRI) is a powerful diagnostic tool, but poses risks with ferromagnetic materials.
  • Patients with cognitive or communication impairments may unknowingly or surreptitiously have metallic foreign bodies.
  • Ingestion of foreign bodies, especially metallic ones, can lead to severe gastrointestinal complications.

Purpose of the Study:

  • To highlight the critical risks of magnetic resonance imaging (MRI) in patients with ingested ferromagnetic foreign bodies.
  • To emphasize the importance of thorough patient screening prior to MRI, particularly in vulnerable populations.
  • To report a rare case of gastric perforation secondary to ingestion of metallic objects before an MRI.

Main Methods:

  • A case presentation of a 65-year-old male with schizophrenia and intellectual disability.
  • Review of the patient's presentation with severe abdominal pain and hypovolemic/septic shock post-scheduled MRI.
  • Surgical retrieval of ingested metallic foreign bodies (sockets and clevis pin) from the stomach.

Main Results:

  • The patient developed hypovolemic/septic shock and gastric perforation after ingesting metallic objects.
  • Surgical intervention was required to remove the foreign bodies and repair the gastric perforation.
  • The incident occurred prior to a scheduled magnetic resonance imaging (MRI) study.

Conclusions:

  • Ingestion of ferromagnetic foreign bodies presents a rare but life-threatening risk during MRI.
  • Challenges in communication and patient debility can obscure the presence of metallic foreign bodies, contraindicating MRI.
  • Vigilant screening and awareness are crucial to prevent catastrophic outcomes in patients undergoing MRI.

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