Abstract
A 16-year-old girl who had had mental retardation since her childhood, visited the hospital complaining of lower abdominal pain developed after ingestion of and anal insertion of a magnet. Magnets were observed in the rectum, but transanal extraction of them was considered difficult. Small intestinal/rectal fistula caused by two magnets was diagnosed from computed tomography (CT) findings. The magnets were expected to be eliminated spontaneously, and conservative therapy was selected. However, the magnets were not excreted spontaneously, and therefore the patient underwent laparoscopic extraction of them on day 20. Two magnets had been attracted to one another and formed a single mass, which was present on the small intestine side submucosa. Because the fistulous lesion at the rectal wall had been cured, the magnets could only be extracted by partial resection of the small intestine. Ingested magnet can cause halation on CT that may make accurate assessment of the location of the magnet difficult. Spontaneous elimination of the ingested magnet does not often take place, so observation of the course must be selected carefully. In this case, delayed surgery enabled extraction of the magnets without giving rectal injury, because the rectal wall had been cured and closed while the magnets retained on the small intestine side.
