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Magnet and button battery ingestion in children: multicentre observational study of management and outcomes
Insights
Ingesting multiple magnets or button batteries (BBs) poses significant risks to children, often requiring medical intervention. International regulation and awareness are crucial to prevent these dangerous paediatric foreign body ingestions.
Area of Science:
- Paediatric Surgery
- Public Health
- Foreign Body Ingestion
Background:
- Magnets and button batteries (BBs) are recognized as dangerous ingested foreign bodies in children.
- The scope and impact of paediatric magnet and BB ingestion in the UK were previously unknown.
Purpose of the Study:
- To investigate current management strategies for paediatric magnet and button battery ingestions in the UK.
- To report on the outcomes and complications associated with these ingestions.
Main Methods:
- A multicentre, retrospective observational study was conducted across 13 UK tertiary paediatric surgery centres.
- Data were collected for children under 17 admitted between October 2019 and September 2020 for magnet or BB ingestion.
Main Results:
- 263 patients were identified: 146 magnet, 112 BB, and 5 mixed ingestions.
- Multiple magnet ingestions frequently required intervention (47.2%), with 9.3% resulting in bowel perforations.
- Button battery ingestions caused morbidity in 12.5% and life-threatening injuries in 1.8%, primarily from oesophageal BBs.
Conclusions:
- Paediatric ingestions of multiple magnets and button batteries are linked to substantial morbidity.
- International action is needed to regulate magnet and BB sales and enhance public awareness of associated risks.
Background:
Magnets and button batteries (BBs) are dangerous ingested foreign bodies in children. The scale and consequences of this public health issue in the UK are unknown. This study aims to report the current management strategies and outcomes associated with paediatric magnet and BB ingestion in the UK.
Methods:
This multicentre, retrospective observational study involved 13 UK tertiary paediatric surgery centres. Children aged under 17 years, admitted between 1 October 2019 and 30 September 2020, following magnet, or BB ingestion were included. Demographics, investigations, management, and complications were recorded.
Results:
In total, 263 patients were identified, comprising 146 (55.5 per cent) magnet, 112 (42.6 per cent) BB, and 5 (1.9 per cent) mixed magnet BB ingestions. Median (interquartile range) age was 4.8 (2.0-9.1) years and 47.5 per cent were female. In the magnet group, 38 (26.0 per cent) children swallowed single magnets, 3 of whom underwent endoscopic retrieval for oesophageal or gastric impaction. Of the 108 (74.0 per cent) children who swallowed multiple magnets, 51 (47.2 per cent) required endoscopic or surgical intervention, predominantly for failure of magnets to progress on serial imaging. Bowel perforations occurred in 10 children (9.3 per cent). Younger age and ingestion of greater numbers of multiple magnets were independently associated with surgery. BB ingestion caused morbidity in 14 children (12.5 per cent) and life-threatening injuries in two (1.8 per cent); the majority were caused by oesophageal BBs (64.3 per cent).
Conclusion:
Multiple magnet and BB ingestions are associated with significant morbidity. Action must be taken at an international level to regulate the sale of magnets and BBs, and to raise awareness of the risks that these objects pose to children.
