From the Research
The best approach for removing magnets from the colon or terminal ileum is through urgent endoscopic or surgical intervention, as evidenced by the most recent and highest quality study 1. If the magnets were recently ingested and are still in the stomach, upper endoscopy may be effective. However, once magnets have reached the colon or terminal ileum, colonoscopy is typically required. In cases where endoscopic retrieval is unsuccessful or if complications like perforation, fistula formation, or obstruction have occurred, surgical intervention becomes necessary. This may involve laparoscopy or open surgery depending on the clinical situation. Some key points to consider in the management of magnet ingestion include:
- Time is critical as multiple magnets can attract across loops of bowel, causing pressure necrosis and perforation within 8-24 hours 2.
- Patients should never be instructed to wait for spontaneous passage, and laxatives are not recommended as they may accelerate movement of magnets through the GI tract, potentially increasing the risk of complications.
- Immediate medical attention is essential, and imaging studies (X-rays) should be performed to locate the magnets precisely before intervention.
- The serious nature of magnet ingestion requires prompt action as delay can lead to significant morbidity requiring more extensive surgical procedures, as highlighted in a case report where a patient underwent successful removal of two magnets in the small intestine by laparoscopy and colonoscopy 1.
- Coordination between pediatric gastroenterologists and pediatric surgeons is recommended for the management of magnet ingestion, especially in cases where endoscopic and surgical interventions are required 1.