Novosti
Khirurgii

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Year 2017 Vol. 25 No 3

EXCHANGE OF EXPERIENCE

V.I. AVERYN¹, S.B. HALUBITSKI², A.V. ZAPALIANSKI³, L.V. VàLIOK³, A.V. NIKULENKOV4

DIAGNOSTICS AND MEDICAL TACTICS IN MAGNETIC FOREIGN BODIES GASTROINTESTINAL TRACT IN CHILDREN

EE "Belarusian State Medical University"¹,
ME "Brest Regional Pediatric Hospital"²,
SI "Republican Scientific And Practical Center of Pediatric Surgery" ³,
ME "Minsk Regional Pediatric Clinical Hospital" 4,
Minsk,
The Republic of Belarus

Objectives. To carry out the analysis of treatment results and to justify therapeutic tactics in patients with in magnetic foreign bodies gastrointestinal tract in children
Methods. From November, 2012 to September 2016, 11 children (6 boys and 5 girls) with magnetic foreign bodies (MFB) were being monitored. The age of the patients ranged from 1 year 10 months to 14 years.
In suspection of the presence of MFB in the gastrointestinal tract all patients underwent conventional radiography of the abdomen, resulted in detection of single or multiple foreign bodies. If MFB were visualized in the projection of the esophagus and the stomach, a child was underwent to fibroesophagogastroduodenoscopy under the endotracheal anesthesia to remove the magnetic foreign bodies.
Results. Many magnetic foreign bodies like any other foreign bodies pass through the gastrointestinal tract spontaneously. If more than one magnet is swallowed, the balls can pull together inside the child’s digestive system, resulting in intestinal obstraction, internal fistulas or perforation of the intestine with the development of peritonitis. The exact time of development of complications is unknown, but there is always a certain time interval within which the damage of the walls of the stomach and intestines develops. Therefore, such patients should be obligatorily hospitalized in the surgical hospital.Accurate localization of a foreign body before it removal is important because tactics of treatment depends on the localization, the time from the moment foreign bodies located in the lumen of the digestive tract and the presence of complications. Retained foreign bodies the gastrointestinal tract are common emergency presentations and their removal prevents the development of severe complications.
Conclusion. The magnets are a special kind of aggressive foreign bodies of the digestive tract, if can cause dangerous complications: intestinal obstruction, perforation of a hollow organ, peritonitis. The «Algorithm for helping children with magnetic foreign bodies of the gastrointestinal tract» is proposed.

Keywords: gastrointestinal tract, foreign bodies, rare-earth magnets, perforation, internal fistulas, peritonitis, intestinal obstruction
p. 317-324 of the original issue
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Address for correspondence:
220116, Republic of Belarus,
Minsk, Dzerzhinsky Ave, 83,
Belarusian State Medical University,
Department of pediatric surgery,
Tel.: 375 017 290-49-23,
E-mail: averinvi@mail.ru
Vasiliy I. Averin
Information about the authors:
Averyn V.I. MD, Professor, Head of department of pediatric surgery, EE "Belarusian State Medical University".
Halubitski S.B. Head of surgical department, ME "Brest Regional Pediatric Hospital".
Zapalianski A.V. PhD, pediatric surgeon, SI "Republican Scientific and Practical Center of Pediatric Surgery".
Valiok L.V. Pediatric surgeon, SI "Republican Scientific and Practical Center of Pediatric Surgery".
Nikulenlov A.V. Head of surgical department, ME "Minsk Regional Pediatric Clinical Hospital".
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