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Comparative Study
. 2021 Jan 15;100(2):e24055.
doi: 10.1097/MD.0000000000024055.

Management of magnetic foreign body ingestion in children

Shuhao Zhang  1 , Lifeng Zhang, Qingjiang Chen, Yuebin Zhang, Duote Cai, Wenjuan Luo, Ken Chen, Tao Pan, Zhigang Gao
Affiliations
Comparative Study

Management of magnetic foreign body ingestion in children

Shuhao Zhang et al. Medicine (Baltimore). .

Abstract

Magnetic foreign bodies ingestion is a special cause for attending emergency department. Here, we aim to analyze the characteristics and treatments of children who ingested magnetic foreign bodies (Buckyballs). Data were collected from children who ingested Buckyballs between February 2017 and October 2019. A retrospective analysis was performed to summarize the experiences of conservative treatment, gastroscopy and surgery when dealing with Buckyballs ingestion.A total of 49 patients with buckyballs ingestion were identified, of whom 11 underwent conservative treatments, 6 underwent gastroscopy, and 32 underwent surgery. Among such individuals, eight patients (72.7%) had a successful conservative treatment (number of Buckyballs [NB]: 3.5[IQR: 2.0-4.0]); four patients (66.7%) had Buckyballs successfully removed by gastroscopy (NB: 3.5[IQR: 3.0-5.5]); 16 asymptomatic (50%) patients (NB: 4.0[IQR: 3.0-8.0]) and 16 symptomatic (50%) patients (NB: 8.5 [IQR: 6.25-11.75]) received emergency surgery. Compared to patients who received conservative treatment, the number of ingested Buckyballs was significantly higher in patients who received surgery or gastroscopy (7.0 [IQR: 3.0-10.75] vs 3.5 [IQR: 2.0-4.0], P < .05). The risk of intestinal perforation was significantly higher in symptomatic patients (P < .05) compared to asymptomatic patients.Gastroscopy is recommended when Buckyballs are in the stomach or esophagus. In asymptomatic patients, conservative treatment can be considered for 4 to 6 days. Patients failing conservative treatment, or those who are symptomatic should undergo emergency surgery.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Imaging of Buckyballs ingestion. (A) Rare-earth neodymium magnets (Buckyballs). (B) Two Buckyballs overlapped on a single view and were misdiagnosed as a single Buckyball. (C) Another abdominal radiography of the same patient shown in (B). (D) Buckyballs in the stomach and colon attracted each other appeared as all the Buckyballs were still in the stomach.
Figure 2
Figure 2
Numbers of ingested Buckyballs and clinical characteristics. (A) Clinical characteristics between the A1 and A2 groups (ADT = abdominal drainage tube). (B) The numbers of ingested Buckyballs in the A1 (asymptomatic patients received emergency surgery), A2 (symptomatic patients received emergency surgery), B1 (patients received conservative treatment successfully), C1 (Buckyballs were removed by gastroscopy successfully) and D (patients received surgery and gastroscopy) groups. (C) Univariate ROC curve analyses of the conservative time of 49 patients were performed to determine the optimal cutoff (Youden index).
Figure 3
Figure 3
Imaging of Buckyballs ingestion. (A) and (B) Buckyballs attracted each other across the loops of the bowels and moved from side-to-side along with the intestines for several days. (C) and (D) Buckyballs were removed by gastroscopy within 5 h, gastric ulcer still occurred. (E) and (F) A patient ingested 73 Buckyballs.
Figure 4
Figure 4
The management algorithm of Buckyballs ingestion.
See this image and copyright information in PMC

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