TREATMENT TACTICS FOR CHILDREN WITH MAGNETIC FOREIGN BODIES OF THE GASTROINTESTINAL TRACT

Twenty clinical cases of magnetic foreign bodies in the gastrointestinal tract in children were analyzed. The age of the affected children ranged from 7 months to 10 years, with an average of 3.7±0.9 years. The main method of detecting magnetic objects in the gastrointestinal tract was radiographic examination of the chest and abdominal organs. Due to the age-specific characteristics of the patients, the anamnestic data (n=12) had a lower percentage of reliability in diagnosing foreign bodies. In three cases, magnetic objects became an intraoperative finding during surgery for suspected appendicular peritonitis. Clinical symptoms of passage of a single magnetic object in the gastrointestinal tract in children were absent. In cases of multiple magnetic objects, nonspecific signs of "acute abdomen" were observed: vomiting, abdominal pain, muscle tension of the anterior abdominal wall, and "black-colored" stool. Single metallic objects were spontaneously evacuated from the digestive tract with conservative management (n=10). Removal of multiple magnetic objects was performed by various methods (n=10). The position of the magnets in the lumen of the esophagus and stomach determined the need for fibroesophagogastroduodenoscopy (n=3). The presence of foreign bodies at various levels of the intestine, in the absence or presence of peritoneal symptoms, required surgical interventions: endovideo-assisted laparoscopy or laparotomy. Complications of magnetic foreign body ingestion were identified during surgical procedures (n=7): intestinal wall perforation, intestinal obstruction, peritonitis, sepsis. Based on the experience gained, a diagnostic and therapeutic strategy has been developed for managing pediatric patients with magnetic foreign bodies in various parts of the gastrointestinal tract.