T o the Editor: We provided care to a 10-year-old girl who had placed 2 Buckyballs magnets in her mouth as a makeshift tongue ring, and accidentally swallowed both magnets. An emergent esophagogastroduodenoscopy revealed that the magnets had passed beyond the duodenum. After 48 hours of conservative management, the magnets appeared to remain in a static position in the right lower quadrant. A limited noncontrast computed tomography scan of the abdomen showed both magnets attached to each other in the appendix. A diagnostic laparotomy was performed and under direct visualization, the magnets were manipulated into the appendix and retrieved via an appendectomy (Fig. 1). Her postoperative course was uneventful. After discharge from the hospital, this case received wide media coverage and was published on the front page of The Washington Post (1). During the same time, 2 other preteens were hospitalized at Inova Fairfax Hospital for Children with similar complaints. Both of them passed the objects spontaneously.Between 10% and 20% of cases require endoscopic retrieval, and approximately 1% of cases require operative management for intestinal obstruction or perforation (2,3) Reports from the Centers for Disease Control and Prevention and the US Consumer Product Safety Commission have described the risks of multiple magnet ingestion and have highlighted the dangers of using magnets as simulated jewelry, particularly around the lips and tongue (4,5). We urge the North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition to assume a leadership role and take the initiative in educating and creating awareness among pediatricians, pediatric gastroenterologists, and other subspecialists about this emerging pediatric health concern.
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