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

Abstract

Over the past 15 years, there has been a noticeable uptick in incidents involving children ingesting multiple magnetic foreign bodies which can cause injuries and gastrointestinal complications including death. The current study aimed to identify the prevalence, clinical presentation, and management of single or multiple magnet ingestions. A retrospective multi-central cross-sectional study was conducted to include all pediatric patients < 18 years presented to the emergency department with ingestion of single or multiple magnets and admitted across hospitals in Qatar, UAE, KSA, Tunisia, and Turkey between January 2011 and December 2021. Demographics, symptoms, management, and outcomes were analyzed. There were 189 magnet ingestions, of which 88 (46.6%) were multiple magnet ingestions. Most patients (55.6%) were male, and the median age was 3.9 (IQR 2–7) years. An abdominal X-ray was obtained in all cases. 119 (62%) patients were conservatively treated, 53 (28%) required surgical intervention and 17 (8.9%) underwent gastroscopy. None of the patients with single magnet ingestions experienced morbidity or severe outcomes. Multiple magnet ingestions led to significant morbidity including hospitalizations, perforations (44.3%), severe intestinal necrosis (19.3%), peritonitis (13.6%), severe abdominal infection (10.2%), and septic shock (4.5%). The rate of surgical intervention (59.1% vs. 1.0%) and gastroscopy (15.9% vs. 3.0%) was significantly higher in the multiple ingestion group compared to the single magnet ingestion group. No deaths were identified. A high risk of serious complications, including the need for surgery to remove the magnets and substantial morbidity may result from swallowing more than one magnet. Magnet safety requirements, public education, and improved legislation are urgently required.

Magnets Playing Hide and Seek: A Case Report of Hidden Magnets in a Child

“…Coins, buttons, batteries, magnets, small toys, pieces of jew-elry, plastic sheets and fruit stones are the commonly ingested FBs [1], and 2% of swallowed FBs are magnets [5]. Ingestion of FBs is associated with significant morbidity and mortality, depending on the size, shape, and patient's physical condition; therefore, endoscopic removal is recommended [1].…”

“…It is important to know that the barriers in finding ingested magnets (or FBs in general) include their attachment to the scope. This will help avoid complications related to the pro-longation of endoscopic procedure, and anesthesia time can also be reduced [5]. In the case of unsuccessful endoscopic procedures, surgery is deemed the next step in management.…”

“…The median age of patients was 3.9 (interquartile range (IQR): 2 -7) years in a more recent multicenter retrospective analysis across multiple countries. The age distribution was: > 50% in the age group 0 -4 years, 34.9% in the age group > 4 to 9 years, and 7.4% in the age group > 9 to ≤ 18 years [5].…”

Magnetic menace: safeguarding children from the growing hazard of multiple magnet ingestion

“…Despite initial regulatory efforts, including a lawsuit against the manufacturer and a federal rule finalized by the U.S. CPSC in 2014, subsequent legal challenges in 2016 overturned the recalls. This reversal has led to a renewed availability of these high-powered magnets on the market and a corresponding increase in related accidents worldwide [2][3][4][5][6][7].…”