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. 2020 Dec 6;8(23):5988-5998.
doi: 10.12998/wjcc.v8.i23.5988.

Surgical treatment of multiple magnet ingestion in children: A single-center study

Duo-Te Cai  1 , Qiang Shu  2 , Shu-Hao Zhang  1 , Jia Liu  3 , Zhi-Gang Gao  1
Affiliations

Surgical treatment of multiple magnet ingestion in children: A single-center study

Duo-Te Cai et al. World J Clin Cases. .

Abstract

Background: Since 2017, the number of magnet ingestion cases has increased year over year in our hospital. Almost all of the ingested magnetic foreign bodies were magnetic beads, and most of the patients experienced intestinal perforations, causing substantial damage.

Aim: To summarize our experience with surgical treatment of multiple magnet ingestion in children.

Methods: The data for general surgeries were collected from January 2010 to April 2020, and the clinical characteristics, treatment methods, and outcomes were summarized and analyzed. Several typical cases were selected and discussed.

Results: Fifty-six cases of ingested magnetic foreign bodies were collected, of which 47 were magnetic beads. The average patient age was 4.7 ± 3.0 years old. The number of ingested magnetic foreign bodies ranged from 2 to 73. There were 26 cases with symptoms at the time of admission, including two cases of shock. Thirteen patients were discharged successfully following conservative treatment and 43 were treated by surgery. Laparotomy was the main method of operation. Laparoscopy was used in four cases, of which three were converted to open surgery, and one was treated successfully using surgery through the navel. Postoperative complications occurred in seven cases, incision infections were observed in six, and adhesive ileus was observed in one.

Conclusion: Clinicians need to summarize their experiences with treating magnetic foreign body ingestions in detail and carry out clinical research to reduce the damage to children.

Keywords: Buckyball; Children; Intestinal perforation; Magnetic bead; Magnetic foreign body; Pediatric surgery.

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Conflict of interest statement

Conflict-of-interest statement: There are no conflicts of interest to report.

Figures

Figure 1
Figure 1
Statistics of ingested foreign body cases of children in our department from 2010 to 2019 (data from January to April 2020 are not included).
Figure 2
Figure 2
Magnetic beads adsorbed between the esophagus and trachea, causing an esophagotracheal fistula. A: Two shadows from the magnetic beads can be seen on the chest radiograph; B: One magnetic bead at the opening of the left bronchus of the tracheal carina can be seen under the tracheoscope; C: After two magnetic beads were removed through the trachea, gastroscopy was performed to assess the esophagus, and a fistula (black arrow) was visible.
Figure 3
Figure 3
Intraoperative photos of two children with shock. A: Several disc magnets adsorbed together, forming a column fistula between two small intestines (orange arrow shows) and resulting in ischemic necrosis of the compressed intestine; B: Inflammatory tissue hyperplasia near the fistula, which formed a strap (blue arrow shows) that compressed the proximal small intestine.
Figure 4
Figure 4
One patient discharged the ingested magnets at different times after ingesting the magnets at different times. The patient was 4 years old. He swallowed two disk magnets at different times, without gastrointestinal symptoms. One magnet was excreted 3 d after swallowing, while the other was excreted 6 d after swallowing.
Figure 5
Figure 5
A 6-year-old patient swallowed two disk magnets by mistake, and presented without gastrointestinal symptoms. The abdominal standing radiograph was obtained during conservative treatment for 4 d (The above Figure A-D showed the abdominal standing radiograph from day 1 to day 4). A magnetic shadow located in the middle and lower abdomen was observed, with obvious relocation between the images. However, two magnets were found in the stomach during operation.
See this image and copyright information in PMC

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