Magnet ingestion in children and its implications: tertiary centre experience

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Emergency Medicine

Background:

• Ingestion of multiple magnets or magnets with other metallic objects poses significant risks, including intestinal obstruction, fistula, and perforation.
• Increased incidence of pediatric magnet ingestion necessitates updated management strategies.
• The magnetic attraction between ingested objects can lead to severe gastrointestinal complications.

Purpose of the Study:

• To review the experience of managing magnet ingestion in children.
• To highlight the risks and complications associated with pediatric magnet ingestion.
• To propose an updated, structured algorithm for managing magnet ingestion in children.

Main Methods:

• A retrospective study included all pediatric patients with magnet ingestion at Bristol Royal Hospital for Children from January 2014 to November 2020.
• Patients with single, multiple magnet, or magnet and metallic object ingestion were analyzed.
• Diagnostic imaging (abdominal X-rays) and interventions (endoscopy, laparotomy/laparoscopy) were recorded.

Main Results:

• A total of 46 pediatric patients with magnet ingestion were identified.
• The number of ingested magnets varied from one to twenty-one.
• Surgical intervention was required in 18 patients for magnet retrieval or complication management, including 8 endoscopic procedures and 10 laparotomies/laparoscopies.

Conclusions:

• Magnet ingestion in children presents complex management challenges.
• Severe complications are frequent and pose substantial risks to pediatric patients.
• An updated, structured algorithm is proposed to guide the management of pediatric magnet ingestion.