Magnet Entrapment in the Right Lower Quadrant: A Management Dilemma

Luks, Valerie L.; Agawu, Atu; Schwartz, Dana; Sreedharan, Raman; Laje, Pablo

doi:10.1177/00099228211008092

Cited by 2 publications

(3 citation statements)

References 9 publications

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“…There were severe outcomes in 12 patients who required surgical intervention with small bowel resection and anastomosis for perforation (n = 4) and fistula (n = 3) or perforation repaired via enterotomy (n = 5). One patient required an appendectomy for magnet entrapment in the appendix (12). All patients with severe outcomes presented with symptoms including abdominal pain (n = 12, 100%), vomiting (n = 7, 58%), decreased oral intake (n = 5, 42%), irritability (n = 1, 8%), and fever (n = 1, 8%).…”

Section: Resultsmentioning

confidence: 99%

Management of Magnet Ingestions at a Large Tertiary Care Children’s Hospital

Shaul

Agawu

Wood

et al. 2022

Journal of Pediatric Gastroenterology &Amp; Nutrition

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Objectives: To review the clinical management and outcomes of magnet ingestions at a large tertiary children's hospital. To determine the association of frequency of high-powered magnet ingestion with the regulation of these magnets. Methods: Children <18 years who presented to the emergency room and were admitted to the Children's Hospital of Philadelphia for ingestion of single or multiple magnets from January 2008 to December 2020 were included. Demographics, symptoms, management, and outcomes were analyzed. The frequency of magnet ingestion was compared over 3 eras: (1) preban (2008)(2009)(2010)(2011)(2012), (2) intra-ban (2013-2016), and (3) post-ban (2017-2020). Results: There were 167 magnet ingestions, including 99 with multiple magnets. Most patients (59%) were male and median age was 6 (interquartile range, 3-9) years. Most single magnet ingestions (86%) were discharged with outpatient monitoring, and none experienced severe outcomes. Multiple magnet ingestions led to significant morbidity including hospitalizations (68%), endoscopic procedures (48%), surgical procedures (14%), and severe outcomes (12%). Most patients (75%) were asymptomatic, however, there was a higher risk of surgery and severe complications based on the presence of symptoms (P = 0.003). The rate of surgical intervention was higher with ≥3 magnets (31.7%) compared to 2 magnets (2.4%) (P < 0.003). Additionally, we found an 160% increase in children with magnet ingestions in the post-ban period (P = 0.021). Conclusions:Multiple magnet ingestion is associated with high morbidity and rate of severe outcomes. There is a relationship between public policy of magnet sale and frequency of magnet ingestion.

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Section: Resultsmentioning

confidence: 99%

Management of Magnet Ingestions at a Large Tertiary Care Children’s Hospital

Shaul

Agawu

Wood

et al. 2022

Journal of Pediatric Gastroenterology &Amp; Nutrition

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“…However, those examinations were inconclusive in our cases. Fluoroscopy can help locate metal FBs during endoscopy or surgery [ 13 , 15 ]. Magnetic resonance imaging (MRI) is strictly contradicted in all cases of metallic FBs ingestion as it may cause catastrophic and life-threatening complications.…”

Section: Discussionmentioning

confidence: 99%

“…With the extreme example of lethal volvulus after ingestion of two magnetic spheres, as mentioned before, the risk of surgery significantly outweighed possible complications. Furthermore, FBs located in the lumen of the appendix are unlikely to be passed yet can cause inflammation or necrosis, even after several years [ 15 ]. Therefore, in both of the presented children, our team consult resulted in surgical exploration after radiologically supported preoperative planning of a laparoscopic approach, as the conservative approach was already dangerously prolonged.…”

Section: Discussionmentioning

confidence: 99%

Removal of Multiple Ingested Magnets Through Laparoscopic Appendectomy in an Adolescent: A Report of Two Cases

Gizewska-Kacprzak,

Nicieja,

Gajek

et al. 2024

Cureus

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Magnet ingestion can lead to serious health issues, including inflammation, gastrointestinal tract perforation, and even life-threatening complications. Despite legislative actions and numerous reports on the dangers of magnet ingestion in children, it remains a significant public health concern. Physicians must remain vigilant in cases of acute abdomen with ambiguous symptoms or unclear history in young patients. Prompt diagnosis and surgical intervention in case of multiple magnet swallowing are crucial to prevent complications. We present two cases of successful removal of ingested magnetic spheres through laparoscopic appendectomy in adolescents. This study aimed to highlight the technical aspects of the procedure to share the benefits of minimally invasive surgery (MIS) in the management of magnetic foreign bodies (FBs) located in the appendix or cecum.

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Magnet Entrapment in the Right Lower Quadrant: A Management Dilemma

Cited by 2 publications

References 9 publications

Management of Magnet Ingestions at a Large Tertiary Care Children’s Hospital

Management of Magnet Ingestions at a Large Tertiary Care Children’s Hospital

Removal of Multiple Ingested Magnets Through Laparoscopic Appendectomy in an Adolescent: A Report of Two Cases

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