Surgical management and morbidity of pediatric magnet ingestions

J Surg Res. 2015 Nov;199(1):137-40. doi: 10.1016/j.jss.2015.04.007. Epub 2015 Apr 8.

Abstract

Background: Foreign body ingestion remains a common reason for emergency room visits and operative interventions in the pediatric population. Rare earth magnet ingestion represents a low percentage of all foreign bodies swallowed by children; however, magnets swallowed in multiplicity can result in severe injuries.

Materials and methods: Pediatric surgeons with membership in the Surgical Section of the American Academy of Pediatrics were surveyed to determine the magnitude and consequences of magnet ingestions in the pediatric population.

Results: About 100 (16%) participant responses reported on 99 magnet ingestions. The median age at ingestion was 3.7 y, and the majority of ingestions (71%) occurred after year 2010. Thirty-two children underwent endoscopy with successful removal in 70% of cases, and multiple magnets were found in 65% of these patients. Seventy-three children required either laparotomy (51) or laparoscopy (22) for magnet removal, and 90% of these children were discovered to have ingested more than one magnet. In addition, 17% of the children were found to have at least one perforation or fistula, and 34% of the children had multiple perforations or fistulae. Nine children required long-term care for their injuries including repeat endoscopies. One child died after hemorrhage from an esophago-aortic fistula.

Conclusions: These results demonstrated the increasing need for magnet regulations and public awareness to prevent potentially serious complications.

Keywords: Earth magnet; Endoscopy; Magnet ingestion; Pediatric.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Eating
  • Endoscopy, Gastrointestinal / statistics & numerical data*
  • Female
  • Foreign Bodies / complications
  • Foreign Bodies / diagnosis
  • Foreign Bodies / epidemiology
  • Foreign Bodies / surgery*
  • Humans
  • Infant
  • Laparoscopy / statistics & numerical data*
  • Laparotomy / statistics & numerical data*
  • Magnets*
  • Male
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Retrospective Studies
  • Surveys and Questionnaires
  • Treatment Outcome
  • United States / epidemiology