LAUSR

A 5-year-old boy with no past medical history presented to a pediatric emergency room after witnessed ingestion of 2 small neodymium magnets from a set of several hundred magnetic beads sold as children’s toys. At presentation, he was asymptomatic and tolerating oral intake. He was hemodynamically stable in the emergency room with a benign abdominal examination. Initial abdominal radiograph demonstrated 2 attached small round foreign bodies in the left upper quadrant with a presumed small bowel location and therefore out of endoscopic reach. He remained clinically well appearing without concern for perforation, obstruction, or volvulus, and so the patient was admitted to the hospital for observation and laxative administration. Serial radiographs over the next 2 days demonstrated progression of the magnets to the right lower quadrant. After passage to the right lower quadrant, the magnets failed to progress despite continued laxative administration prompting an attempt at endoscopic retrieval on hospital day 3. During the colonoscopy, the magnets were visible under fluoroscopy (Figure 1) but were never visualized in the lumen of the ileum or the colon despite adequate bowel preparation. After the colonoscopy, radiographs continued to demonstrate the magnets in the right lower quadrant (Figure 2), so ultrasound was performed and identified the magnets within the lumen of the appendix (Figure 3).