Silent and Spontaneous Excretion of Two Magnets Pinching the Gut

CASE REPORT A previously healthy 13-year-old adolescent girl presented to our hospital after ingesting 2 neodymium magnets. Gastrointestinal injury was suspected; hence, abdominal radiograph was performed to assess the location of the magnets and complications due to the foreign body. Radiograph revealed 2 magnets located separately in the ascending colon (Figure 1). The following day, the magnets were found to be attached on radiograph (Figure 1), and we attempted their removal by colonoscopy.Figure 1.: (A) X-rays performed immediately after the patient arrived at the hospital showed the presence of 2 magnets (arrows) separated in the ascending colon. (B) The next day, however, the 2 magnets had stuck.(arrow). (C) Colonoscopy revealed an ascending colon fold trapped between 2 magnets.(arrow). (D) Recolonoscopy revealed the fistula had completely healed.(arrow).Endoscopy showed that an ascending colon fold was sandwiched between the 2 magnets (Figure 1), and the magnetic force was too strong to attempt removal. She was asymptomatic; hence, surgical removal of magnets was avoided. The magnets were still attached on radiograph 5 days later, but another follow-up radiograph 10 days later did not show the magnets (Figure 1). The magnets probably traveled spontaneously through the fistula and were excreted in her stool. A follow-up colonoscopy, after one month, showed well-healed scar at the previous fistula site. This is a rare case in which 2 magnets formed a fistula in the folds of the ascending colon but were eventually excreted, with spontaneous fistula closure. DISCLOSURES Author contributions: R. Miyamoto, H. Honma, Y. Masuda, and A. Okumura drafted and edited the manuscript. All authors approved the final version. R. Miyamoto is the article guarantor. Financial disclosure: None to report. Informed consent was obtained for this case report.