Successful removal of multiple magnetic foreign bodies in the digestive tract of children by gastroscopy: Two case reports

RATIONALE: Gastrointestinal foreign body (FB) is an emergency commonly encountered by the pediatric gastroenterology department. Management of their extraction requires knowledge and careful consideration of removal techniques. PATIENT CONCERNS: Two little girls swallowed multiple magnets that stuck together for >3 days, which was an indication for surgery. DIAGNOSIS: X-ray revealed dense shadows in the left abdomen. However, the abdominal examination revealed a soft abdomen without tenderness, rebound tenderness, or muscle rigidity. INTERVENTION: The multiple magnets were removed by endoscopy instead of surgery. OUTCOME: We conducted sufficient preoperative assessment and preparation. Eventually, we successfully removed the multiple magnets by endoscopy, and no perforation or fistula formation was observed. Surgery was avoided. LESSONS: Swallowing multiple magnets isn’t a rare emergency in children. Physicians must be aware that surgery is not the only option even if multiple magnets are swallowed for >12 hours. Endoscopic removal can be considered if there is no obstruction, perforation, or fistula formation upon careful patient assessment. If endoscopic removal fails, surgical treatment should be performed as soon as possible to avoid serious complications.