A 20-year-old man was admitted for ingestion of four nails two days earlier. He reported intermittent abdominal pain. Physical examination revealed no significant abnormalities. Abdominal imaging showed several long rods in the stomach, without signs of perforation (Fig. 1A). Upper endoscopy found that the nails had moved to distal duodenum. We used a grasping forceps to grip one of the nails, but duodenal wall was compressed by other two nails (Fig. 1B). Further attempts using the grasping forceps alone were abandoned. Considering the difficulty in trapping the movable nails together, we turned to use two powerful ring-shaped magnets, that were attached with strings and inserted using the forceps along with the re-introduction of the endoscope. The retained nails and the inserted magnets were drawn together immediately. To avoid additional injury to the wall, we adjusted the binding point to the proximal ends of the nails by gentle rotation of the endoscope and repeated suction and inflation (Fig. 1C). Along with the direction of the lumen, we easily removed all the four nails as we withdrew the endoscope (Fig. 1D). There were no additional damages to digestive tract, and the patient was discharged subsequently. Our experience suggested that magnets can play a promising role in retrieval of magnetic objects when it is difficult or risky to operate using conventional devices like snare and grasping forceps.1–3
Informed consent was obtained from the patient for the publication of his information and imaging.
Conflicts of interestAll authors disclose no conflicts relevant to this article.
We acknowledge the support from 1·3·5 project for disciplines of excellence – Clinical Research Incubation Project, West China Hospital, Sichuan University (20HXFH016).
