Gastrocolic fistula following ingestion of magnets.

A 3 year old male child presented with history of ingestion of 3 magnetic foreign bodies about 10 days back and had undergone upper GI endoscopy 3 days back elsewhere, where only one magnetic foreign body could be retrieved from the lumen of stomach and rest of the foreign bodies could not be visualized. Patient was symptomatic and was having pain abdomen so the child was referred to I Q City Hospital. At presentation X-ray of the abdomen showed 2 oval radio-opaque foreign bodies in the left hypochondrium. Patient was taken up for exploratory laparotomy. During surgery, one foreign body was present in the lumen of large intestine at splenic flexure, which was milked out and removed per anus. But the second foreign body was not palpable either in the lumen of the large intestine or the stomach. The splenic flexure was completely mobilized. The wall of the large intestine was found to be grossly adherent to the wall of the stomach near the greater curvature.  The second foreign body was palpable in the fistulous connection between the stomach and large intestine. The Gastrocolic fistula was completely delineated and opened to extract the foreign body, the stomach wall was repaired primarily, but the colonic wall around the fistula was unhealthy with leakage of frankly feculent material. Colonic wall was also repaired with creation of diversion ileostomy. Patient did well after the surgery and was discharged on 6th postoperative day.