A magnet-induced stomach ulcer causing abdominal pain

A 24-year-old female with a history of major depressive disorder, borderline personality disorder, and post-traumatic stress disorder presented complaining of worsening abdominal pain over the last 48 h. She reported previously watching an episode of a television medical drama in which a patient swallowed magnets and found out this was very dangerous. She then tried this herself and swallowed multiple cylindrical magnets. Her vital signs were stable. The abdomen was tender but there was no rebound or guarding. The abdominal X-ray showed a cylindrical column in the patient’s stomach (Fig. 1). An emergent esophagogastroduodenoscopy (EGD) was performed, which showed one cylindrical magnet magnetized through the stomach wall to another two cylindrical magnets (Fig. 2A). Multiple attempts were made to remove the magnets but the magnetic force continued to keep the magnets adherent to each other. Eventually, using a Roth Net, one magnet was bent laterally and all three cylindrical magnets were dislodged off the mucosa and attached together as one large magnet that was removed through her mouth. However, given the prolonged magnet compression of the stomach mucosa, two cratered oozing ulcers were noted at the sites of the magnets (Fig. 2B). Epinephrine was injected and endoclips were applied with successful hemostasis. This case highlights that ingestion of magnets can cause abdominal pain due to ulcer formation from prolonged magnet compression of the stomach mucosa. Urgent evaluation and EGD should be considered [1,2]. It can be difficult to remove magnets during EGD, and a Roth Net can be used to facilitate their removal [1,2].