Surgical management of pediatric multiple magnet ingestions in the past two decades of minimal access surgery- systematic review of operative approaches

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

“…Notably, the period between the ingestion and the onset of symptoms can vary significantly, lasting up to 40 days [6]. The majority of patients are asymptotic but may also present with nonspecific symptoms like abdominal pain or distension, vomiting, loss of appetite, and fever [6,7]. Unfortunately, in some cases, the progression is rapid and fatal.…”

“…Yet, it is difficult to estimate when the patient's medical history is unclear. It is especially prominent in the case of very young patients, as almost 3/4 of incidences are unwitnessed [7]. Additionally, their diameter can also impact the prognosis, with magnets smaller than 5 millimeters being associated with higher morbidity [1].…”

“…However, it is hazardous if not caught early, involves multiple magnets, or if a battery is co-ingested [1][2][3][4][5]. Even two magnets located at different levels of the intestine can merge through bowel loops and cause various life-threatening complications, including numerous perforations of the gastrointestinal tract (GI), ischemia or necrosis of the intestines, the development of fistulas, peritonitis, and obstruction [4,[6][7][8][9]. Therefore, magnetic sphere ingestion can pose a significant health risk in a pediatric population.…”

“…Children under six years of age are at highest risk, and most of them are boys [10]. There is no typical presentation in magnet ingestion, so a child's age, reluctance, or inability to describe circumstances can delay diagnosis [4][5][6][7][8]. The issue led to the implementation of legislative regulations at the federal level in 2012 to prohibit magnetic toy distribution in the United States of America [1].…”

“…Sixty percent of patients undergo explorative laparotomy, and only 20% of surgeries are entirely laparoscopic. Magnets are removed with an appendectomy in 3% of cases [7]. In the era of widespread minimally invasive surgery (MIS) in children, we present two cases of successful laparoscopic management of multiple magnet ingestion.…”