Intestinal Fistulas caused by Ingestion of Magnets in an Adult

Yoshifumi Nishi, Koji Sasajima, Takeshi Matsutani, Masayuki Miyamoto, Hiroshi Maruyama, Tadashi Yokoyama, Ken Yanagi, Akihisa Matsuda, Moto Kashiwabara and Takashi Tajiri*

Department of Surgery, Nippon Medical School Tama-Nagayama Hospital
Department of Surgery, Nippon Medical School Hospital*

A 44-year-old autistic man undergoing psychiatric therapy at a mental health center was admitted 1 week after ingesting magnets due to abdominal pain with pyrexia. Laboratory data showed severe inflammation and abdominal X-ray, and computed tomography showed 9 intestinal metallic foreign bodies necessitating emergency surgery to remove 9 magnets used in psychiatric treatment. Duodeno-jejunal and jejunojejunal fistula were found at points of magnet contact with the duodenum and jejunum. Magnets were removed and the necrotic duodenum and jejunum partially resected together with the fistula. Duodenojejunostomy, jejunojejunostomy, and duodenostomy with an 8 Fr Atom catheter were successful and the postoperative course was uneventful. Although 26 cases of magnet ingestion have been reported in children in the world, to our knowledge, this is a first such report involving intestinal perforation and fistula after magnet ingestion in an adult.

Key words
magnet ingestion, intestinal foreign body, intestinal fistula

Reprint requests
Yoshifumi Nishi Department of Surgery, Nippon Medical School Tama-Nagayama Hospital
1-7-1 Nagayama, Tama, 206-8512 JAPAN

Accepted
May 21, 2008

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