Neodymium magnets migrated into an internal supravesical hernia: a rare case of foreign body ingestion in children

Abstract Background Foreign body (FB) ingestion is a common event in children. The management of the ingested FB depends on the location, type, number, size of the FBs, patient age, and symptoms. Although most FBs pass spontaneously through the gastrointestinal tract without causing serious injuries...

Full description

Saved in:
Bibliographic Details
Main Authors: Michiaki Ikegami, Yuichiro Miyaki, Takashi Hamano, Yurina Taira, Toshiaki Takahashi
Format: Article
Language:English
Published: Japan Surgical Society 2023-07-01
Series:Surgical Case Reports
Subjects:
Online Access:https://doi.org/10.1186/s40792-023-01713-9
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849709703530020864
author Michiaki Ikegami
Yuichiro Miyaki
Takashi Hamano
Yurina Taira
Toshiaki Takahashi
author_facet Michiaki Ikegami
Yuichiro Miyaki
Takashi Hamano
Yurina Taira
Toshiaki Takahashi
author_sort Michiaki Ikegami
collection DOAJ
description Abstract Background Foreign body (FB) ingestion is a common event in children. The management of the ingested FB depends on the location, type, number, size of the FBs, patient age, and symptoms. Although most FBs pass spontaneously through the gastrointestinal tract without causing serious injuries, the ingestion of multiple high-powered magnetic pieces, especially neodymium magnets (NMs) increases the risks of morbidity and mortality. Supravesical hernia (SH) is rarely occurs in children, and few studies have reported SH in pediatric patients. We report an extremely rare case of ingested NMs that migrated into an internal SH in a pediatric patient. Case presentation A 3-year-old boy who had accidentally swallowed two NMs 3 days ago presented with vomiting and lower abdominal pain. X-ray imaging and computed tomography (CT) suspected the presence of a 1.0-cm radiopaque FB located in the terminal ileum dorsal side of the bladder. Although his abdominal pain was gradually getting better after oral feeding, repeat abdominal X-ray imaging showed that the FB was in a stagnant in position. Therefore, surgical intervention was planned to remove the FB 1 week after his admission. Under general anesthesia, laparoscopic and fluoroscopic examinations were performed and the cecum was found adhered to the retroperitoneum between the right medial umbilical fold and the right wall of the urinary bladder. The FB was presumed to be located at the tip of the incarcerated cecum in the retroperitoneal space. Peritoneum incision was started near the medial inguinal fossa, and the Retzius space was opened in a manner similar to the transabdominal pre-peritoneal approach for inguinal hernia repair. Consequently, the patient was diagnosed with internal SH with FB migration. The incarcerated cecum was pulled out, which revealed intestinal wall perforation. The FB remained in the retroperitoneal space in the pelvic cavity. The FB was easily removed using intestinal forceps and identified as combined two NMs. The postoperative course was good, and the patient was discharged on postoperative day 5. Conclusions We experienced an extremely rare case of a pediatric patient who swallowed multiple NMs that migrated into an internal SH, and the laparoscopic minimally invasive removal was successful.
format Article
id doaj-art-1f7ae24b040e4e8a9a7fa547990f3939
institution DOAJ
issn 2198-7793
language English
publishDate 2023-07-01
publisher Japan Surgical Society
record_format Article
series Surgical Case Reports
spelling doaj-art-1f7ae24b040e4e8a9a7fa547990f39392025-08-20T03:15:12ZengJapan Surgical SocietySurgical Case Reports2198-77932023-07-01911510.1186/s40792-023-01713-9Neodymium magnets migrated into an internal supravesical hernia: a rare case of foreign body ingestion in childrenMichiaki Ikegami0Yuichiro Miyaki1Takashi Hamano2Yurina Taira3Toshiaki Takahashi4Department of Pediatric Surgery, Seirei Hamamatsu General HospitalDepartment of Surgery, Seirei Hamamatsu General HospitalDepartment of Colorectal Surgery, Seirei Hamamatsu General HospitalDepartment of Pediatric Surgery, Seirei Hamamatsu General HospitalDepartment of Pediatric Surgery, Seirei Hamamatsu General HospitalAbstract Background Foreign body (FB) ingestion is a common event in children. The management of the ingested FB depends on the location, type, number, size of the FBs, patient age, and symptoms. Although most FBs pass spontaneously through the gastrointestinal tract without causing serious injuries, the ingestion of multiple high-powered magnetic pieces, especially neodymium magnets (NMs) increases the risks of morbidity and mortality. Supravesical hernia (SH) is rarely occurs in children, and few studies have reported SH in pediatric patients. We report an extremely rare case of ingested NMs that migrated into an internal SH in a pediatric patient. Case presentation A 3-year-old boy who had accidentally swallowed two NMs 3 days ago presented with vomiting and lower abdominal pain. X-ray imaging and computed tomography (CT) suspected the presence of a 1.0-cm radiopaque FB located in the terminal ileum dorsal side of the bladder. Although his abdominal pain was gradually getting better after oral feeding, repeat abdominal X-ray imaging showed that the FB was in a stagnant in position. Therefore, surgical intervention was planned to remove the FB 1 week after his admission. Under general anesthesia, laparoscopic and fluoroscopic examinations were performed and the cecum was found adhered to the retroperitoneum between the right medial umbilical fold and the right wall of the urinary bladder. The FB was presumed to be located at the tip of the incarcerated cecum in the retroperitoneal space. Peritoneum incision was started near the medial inguinal fossa, and the Retzius space was opened in a manner similar to the transabdominal pre-peritoneal approach for inguinal hernia repair. Consequently, the patient was diagnosed with internal SH with FB migration. The incarcerated cecum was pulled out, which revealed intestinal wall perforation. The FB remained in the retroperitoneal space in the pelvic cavity. The FB was easily removed using intestinal forceps and identified as combined two NMs. The postoperative course was good, and the patient was discharged on postoperative day 5. Conclusions We experienced an extremely rare case of a pediatric patient who swallowed multiple NMs that migrated into an internal SH, and the laparoscopic minimally invasive removal was successful.https://doi.org/10.1186/s40792-023-01713-9Neodymium magnetForeign body ingestionChildrenLaparoscopic removal
spellingShingle Michiaki Ikegami
Yuichiro Miyaki
Takashi Hamano
Yurina Taira
Toshiaki Takahashi
Neodymium magnets migrated into an internal supravesical hernia: a rare case of foreign body ingestion in children
Surgical Case Reports
Neodymium magnet
Foreign body ingestion
Children
Laparoscopic removal
title Neodymium magnets migrated into an internal supravesical hernia: a rare case of foreign body ingestion in children
title_full Neodymium magnets migrated into an internal supravesical hernia: a rare case of foreign body ingestion in children
title_fullStr Neodymium magnets migrated into an internal supravesical hernia: a rare case of foreign body ingestion in children
title_full_unstemmed Neodymium magnets migrated into an internal supravesical hernia: a rare case of foreign body ingestion in children
title_short Neodymium magnets migrated into an internal supravesical hernia: a rare case of foreign body ingestion in children
title_sort neodymium magnets migrated into an internal supravesical hernia a rare case of foreign body ingestion in children
topic Neodymium magnet
Foreign body ingestion
Children
Laparoscopic removal
url https://doi.org/10.1186/s40792-023-01713-9
work_keys_str_mv AT michiakiikegami neodymiummagnetsmigratedintoaninternalsupravesicalherniaararecaseofforeignbodyingestioninchildren
AT yuichiromiyaki neodymiummagnetsmigratedintoaninternalsupravesicalherniaararecaseofforeignbodyingestioninchildren
AT takashihamano neodymiummagnetsmigratedintoaninternalsupravesicalherniaararecaseofforeignbodyingestioninchildren
AT yurinataira neodymiummagnetsmigratedintoaninternalsupravesicalherniaararecaseofforeignbodyingestioninchildren
AT toshiakitakahashi neodymiummagnetsmigratedintoaninternalsupravesicalherniaararecaseofforeignbodyingestioninchildren