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Abstract
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Abdominal pain in pediatric patients is one of the most common causes for consultation at the emergency1 and primary care services2. The principal medical cause of gastrointestinal abdominal pain in pediatric patients is gastroenteritis whereas the surgical cause is appendicitis3. The diagnosis of patients with abdominal pain is based principally on the medical history, physical examination, and complementary studies1. In the case of complementary studies, a simple abdominal radiograph is useful when an obstruction or intestinal fistula is suspected3. The fistula of a part of the gastrointestinal tract secondary to foreign body intake occurs in 1% of the patients who ingest these bodies and can manifest as abdominal pain difficulting its diagnosis4. Our objective is to report a case of a 5-year-old child with ileocecal fistula secondary to magnetic foreign body ingestion.
A 5-year-old male patient attended the Emergency Department after presenting a 1-day-history of intense epigastric pain. During physical exam he had axillary temperature of 37 °C and a soft, depressive, and tender abdomen to palpation at the epigastric level. Laboratory exams reported hematocrit 33%, hemoglobin 12.6 g/dl, leukocytes 12.4 x 103/ul, platelets 317 x 103/ul, AST 39 U / L, alkaline phosphatase 292 IU/L, amylase 34 UI/L, and lipase 56 UI/L. A simple x-ray of the abdomen was performed, where multiple rounded images of defined margins and high density (metal) in number of 6 at the right iliac fossa level, ileal airway levels, and preserved preperitoneal lines were visualized.
At the directed anamnesis the mother reported that her son swallowed several metallic objects playing days ago. A re-evaluation was suggested at 24 hours waiting for these foreign bodies to continue the intestinal trajectory. The following day simple abdominal x-ray was repeated visualizing no migration of foreign bodies, surgical intervention was decided...
El dolor abdominal en los pacientes pediátricos es uno de los motivos de consulta más comunes tanto en las emergencias1 como en servicios de atención primaria2=. La principal causa médica de dolor abdominal de tipo gastrointestinal en pacientes pediátricos es la gastroenteritis mientras que la de causa quirúrgica es apendicitis3. El diagnóstico de los pacientes con dolor abdominal se basa principalmente en la historia clínica, examen físico y estudios complementarios1. En lo que respecta a los estudios complementarios, cuando se sospecha una obstrucción o fístula intestinal tiene bastante utilidad la radiografía simple de abdomen3. La fístula de algún trayecto del aparato digestivo secundario a ingesta de cuerpos extraños, ocurre en el 1% de los pacientes que ingieren estos cuerpos y se pue- de manifestar como dolor abdominal dificultando el diagnóstico4. El objetivo es reportar un caso de un niño de 5 años con fistula íleo-cecal secundaria a ingesta de cuerpo extraño magnético.
Keywords: Multiple magnet ingestion
Language: es |