Magnet and button battery ingestion in children: multicentre observational study of management and outcomes

Abstract

Background Magnets and button batteries (BBs) are dangerous ingested foreign bodies in children. The scale and consequences of this public health issue in the UK are unknown. This study aims to report the current management strategies and outcomes associated with paediatric magnet and BB ingestion in the UK. Methods This multicentre, retrospective observational study involved 13 UK tertiary paediatric surgery centres. Children aged under 17 years, admitted between 1 October 2019 and 30 September 2020, following magnet, or BB ingestion were included. Demographics, investigations, management, and complications were recorded. Results In total, 263 patients were identified, comprising 146 (55.5 per cent) magnet, 112 (42.6 per cent) BB, and 5 (1.9 per cent) mixed magnet BB ingestions. Median (interquartile range) age was 4.8 (2.0–9.1) years and 47.5 per cent were female. In the magnet group, 38 (26.0 per cent) children swallowed single magnets, 3 of whom underwent endoscopic retrieval for oesophageal or gastric impaction. Of the 108 (74.0 per cent) children who swallowed multiple magnets, 51 (47.2 per cent) required endoscopic or surgical intervention, predominantly for failure of magnets to progress on serial imaging. Bowel perforations occurred in 10 children (9.3 per cent). Younger age and ingestion of greater numbers of multiple magnets were independently associated with surgery. BB ingestion caused morbidity in 14 children (12.5 per cent) and life-threatening injuries in two (1.8 per cent); the majority were caused by oesophageal BBs (64.3 per cent). Conclusion Multiple magnet and BB ingestions are associated with significant morbidity. Action must be taken at an international level to regulate the sale of magnets and BBs, and to raise awareness of the risks that these objects pose to children.

Magnet ingestion in growing children: a multi-center observational study on single and multiple magnet incidents

“…A case series reported small intestine affection in the jejunal and ileum 30 . A recent multi-center cross-sectional study reported that the initial site of multiple magnet ingestion was the stomach (52%) followed by the small intestine (29%) 31 . This study found that nearly 69% of multiple magnet ingestion cases had their small intestine afflicted.…”

“…Another study showed that 75% of children required hospitalization for multiple magnet ingestions 14 . A multi-center study reported that the median hospital stay for magnet ingestions was 1.0 (0–3.0) days 31 . This study demonstrated that the LOS increased in patients who needed surgical intervention reaching 20.8% (n = 53) of the total patients who underwent surgery.…”

Evolving threat of pediatric ingestions: a discussion of cannabis and button batteries and their implications for children

“…Children less than 6 years of age are at increased risk of esophageal impaction given their smaller diameter esophagus [3]. Older children may also ingest foreign bodies accidently or purposely, especially in the setting of autism spectrum disorder or attention deficit and hyperactivity disorder [4].…”

Diagnosis, management and prevention of button battery ingestion in childhood: a European Society for Paediatric Gastroenterology Hepatology and Nutrition position paper

“…Button battery (BB) ingestions are a serious risk in the paediatric population, the complications of which involve gastrointestinal (GI), respiratory and vascular structures, and include perforation, stenosis, inflammation and fistulation 1. While information on UK incidence is presently unknown, child death due to BB ingestion has been the focus of a recent Healthcare Safety Investigations Branch (HSIB) inquiry2 and an NHS National Patient Safety Alert,3 both highlighting the significant risk this poses to children worldwide.…”