Retrospective analysis of pediatric patients with multiple rare-earth magnets ingestion: a single-center experience from China

Abstract

Background The aim of this study was to characterize patients who ingested multiple rare-earth magnets, reveal the harm of rare-earth magnet foreign bodies in the digestive tract, and develop a clinical management algorithm. Methods This was a retrospective review of patients with rare-earth magnet foreign bodies in the digestive tract admitted to a university-affiliated pediatric medical center in China, between January 2016 and December 2019; the subset of medical data evaluated included clinical symptoms, signs, treatments and outcomes. Results A total of 51 cases were included in this study, including 36(70.6%) males and 15(29.4%) females. The magnets were passed naturally in 24(47.1%) patients and removed by intervention in 27(52.9%) patients, including 5(9.8%) cases by endoscopy and 22(43.1%) cases by surgery. Twenty-two (43.1%)cases had gastrointestinal obstruction, perforation, and fistula. Compared with the non-surgical group, the time of the surgical group from ingestion to arriving at the hospital was longer([80(5–336) vs 26(2–216)]hours, p < 0.001) while there was no significant difference in the mean age or the number of magnets swallowed. Conclusions Magnets are attractive to children, but lead to catastrophic consequences including gastrointestinal obstruction, perforation, and surgical interventions when ingested multiple magnets. Endoscopic resection should be urgently performed in the presence of multiple magnets as early as possible within 24 h, even in asymptomatic patients.

A clinical study involving 72 cases of multiple magnetic beads in the gastrointestinal tract of children

“…However, there were no signi cant differences between the perforated and the non-perforated group in terms of mean age, gender, medical history, and the number of magnetic beads ingested (P > > 0.05). These ndings were similar to those obtained by Zheng et al [22] .…”

“…The rare-earth magnets used in toys are generally small and, accordingly, the perforation caused by their ingestion will be correspondingly small. In some cases, due to wrapping of the omentum following perforation or the direct formation of an internal stula, the clinical symptoms tend to be mild, and the ndings obtained via imaging tend to be atypical [22] .…”

“…Compared with the non-surgical group, the peripheral WBC count (P = 0.048) and the CRP level (P = 0.033) were both higher in the surgical group. A high WBC count and/or CRP level suggest a high possibility of perforation, and surgical treatment is required as soon as possible in such cases [22] . However, there were no signi cant differences between the perforated and the non-perforated group in terms of mean age, gender, medical history, and the number of magnetic beads ingested (P > > 0.05).…”

Contained Jejunal Perforation Secondary to Ingestion of Magnet Balls in a Nonfatal Drowning Child

“…Magnets have a high risk of requiring surgical intervention for removal. About 1% of cases require surgical treatment for foreign body retention or associated complications [ 4 ]. One retrospective analysis from a single-center experience from China published in 2021 showed the majority of magnet ingestion cases were asymptomatic [ 4 ].…”

“…About 1% of cases require surgical treatment for foreign body retention or associated complications [ 4 ]. One retrospective analysis from a single-center experience from China published in 2021 showed the majority of magnet ingestion cases were asymptomatic [ 4 ]. In another study published by The American Academy of Pediatrics in March 2022 about 46% of children’s hospital patients who ingested magnets needed endoscopy and/or surgery [ 5 ].…”