Laparoscopic Removal of Multiple Ingested Magnets Using the Appendix and Meckel's Diverticulum: A Case Report.

There has been a marked increase over the last two decades in pediatric cases involving ingestion of multiple magnets, which can cause serious, potentially life-threatening gastrointestinal complications. More than half of such incidents require surgery, and nearly three-quarters are managed via laparotomy. Magnet extraction through laparoscopic appendectomy has been described as a viable, minimally invasive method in selected cases. We report the case of a seven-year-old boy with a staggered ingestion of two magnetic spheres. The initial abdominal radiograph showed the magnets in separate locations. An urgent endoscopic retrieval attempt was unsuccessful, and subsequent radiographs demonstrated that the magnets adhered to each other in a fixed position. Diagnostic laparoscopy revealed the magnets causing an adhesion between the caecal wall and the ileum with signs of imminent perforation. The magnet located in the cecum was removed via appendectomy. Inspection of the small bowel loops revealed a Meckel's diverticulum. The second magnet was guided into the diverticulum, secured with an endoclip, and the diverticulum containing the magnet was then exteriorized through the umbilicus and resected. This report highlights the effectiveness of appendectomy in the removal of ingested magnets. It also underscores the importance of thoroughly inspecting the small bowel during laparoscopy, as unexpected anatomical findings (such as a Meckel's diverticulum) may influence the surgical strategy.