A 27-month-old previously healthy boy came to the emergency department, with repeated vomiting, sweating, generalized weakness, dizziness, anxiety, and reduced consciousness. The patient was in shock and intestinal necrosis requiring extensive intestinal resection.
A 27-month-old previously healthy boy presented to the emergency department with repeated vomiting, sweating, generalized weakness, dizziness, anxiety, and reduced consciousness. He was found to be in shock with a heart rate of 200 beats per minute, respiratory rate of 49 breaths per minute, and blood pressure of 84/43 mmHg. The abdomen was soft but grossly distended with sluggish bowel sounds.
Arterial blood gas revealed metabolic acidosis with a pH of 7.12 and base excess of −14. The arterial lactate level was 5 mmol/L. Initial abdominal radiography showed diffuse bowel dilatation but no apparent air-fluid level and two circular radiopaque opacities in the bowel suggestive of metallic foreign bodies. The patient was admitted to the paediatric intensive care unit for resuscitation.
He was stabilized with intravenous fluids and ionotropic support. Emergency laparotomy revealed small bowel obstruction with extensive necrosis. Approximately 107 cm of gangrenous small bowel was resected, and end-to-end anastomosis was performed.
Two magnetic beads sized 5 mm × 5 mm were found, one in the small bowel and the other in the right colon. The magnetic beads were removed. Postoperative recovery was uneventful. Retrospective questioning of the parents revealed no history suspicious of FB ingestion.