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Published on: September 11, 2018
Clinical characteristics of magnetic foreign body misingestion in children
Yu Kun Huang1, Shao Xian Hong1, I Hsin Tai2,3
1Department of Critical Care Medicine, Children's Hospital of Fudan University Xiamen Branch, Xiamen, 361006, Fujian, China.
Abstract:
Magnetic foreign body misingestion (MFBM) is now occurring more frequently. It may cause remarkable mortality and morbidity in children. A retrospective analysis of the clinical data of children admitted to Xiamen Children's Hospital between March 2017 and July 2020 due to accidental MFBM. A total of 14 children who had MFBM were collected, the proportion between urban and rural areas was 8:6, and the ratio of male to female was 6:1. The age ranged from 1.2 to 8.9 years (median 4.6 years). The number of magnetic foreign bodies ingested by mistake is 1 to 17 (average 6.5). Magnetic foreign objects are divided into magnets (3 cases) + magnetic beads (11 cases). About 40% (5/14) of this patient series showed no available misingestion history. Management includes: 4 cases of open surgery (including 1 case of laparoscopic transfer to operation), 3 cases of laparoscopic surgery, 2 cases of gastroscopy, 5 cases of conservative treatment of foreign bodies discharged through the anus. Of the 7 surgical cases, 6 cases presented with intestinal obstruction and intestinal perforation (at least 1 intestinal perforation and at most 5). Abdominal sonography has limitations in the detection of magnetic foreign bodies in the digestive tract. The proportion of laparoscopic surgery in the 7 surgical cases is nearly half. All surgical cases recovered smoothly after treatment. Our experience shows that MFBM is a big issue for the small children! The early symptoms of MFBM are often atypical especially among young children and MFBM may lead to severe adverse events. We proposed a management strategy for MFBM in children. We advise pediatricians/emergency physicians, parents/children's guardians and society should raise the collaborated alertness of MFBM. Global awareness of risk prevention of magnetic material accidental ingestion cannot be overemphasized.
Insights
Accidental ingestion of magnetic foreign bodies (MFBM) is a growing concern in children, often presenting with atypical symptoms and leading to severe complications. Early detection and a clear management strategy are crucial for positive outcomes.
Area of Science:
- Pediatric Gastroenterology
- Pediatric Surgery
- Medical Device Safety
Background:
- Magnetic foreign body misingestion (MFBM) is an increasing pediatric health issue with significant morbidity and mortality risks.
- Accidental ingestion of magnets and magnetic beads poses a serious threat to children, often due to a lack of ingestion history.
- Early symptoms of MFBM can be atypical, complicating diagnosis and timely intervention in young children.
Purpose of the Study:
- To analyze the clinical characteristics and management outcomes of pediatric patients with accidental magnetic foreign body misingestion.
- To evaluate the effectiveness of different treatment modalities, including surgical and conservative approaches.
- To propose an optimized management strategy for MFBM in children to mitigate adverse events.
Main Methods:
- Retrospective analysis of clinical data from 14 children admitted to Xiamen Children's Hospital between March 2017 and July 2020 for accidental MFBM.
- Review of patient demographics, ingested object types (magnets, magnetic beads), ingestion history, clinical presentation, and management strategies.
- Assessment of diagnostic imaging limitations (abdominal sonography) and treatment outcomes, including surgical interventions (open and laparoscopic) and conservative management.
Main Results:
- 14 pediatric cases of MFBM were identified, with a male predominance (6:1) and a median age of 4.6 years.
- Magnetic beads were the predominant ingested objects (11/14 cases); 40% of cases lacked a clear ingestion history.
- Surgical intervention was required in 7 cases, with 6 experiencing intestinal obstruction and/or perforation; all surgical patients recovered, and laparoscopic surgery was utilized in nearly half of these cases.
Conclusions:
- MFBM represents a significant pediatric challenge requiring heightened awareness due to potential severe complications and atypical early symptoms.
- A structured management strategy is essential for addressing MFBM in children, emphasizing early recognition and appropriate intervention.
- Collaborative vigilance among healthcare providers, parents, and society is crucial for preventing accidental magnetic material ingestion and improving patient outcomes.
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