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Individualized Treatment of Multiple Magnetic Foreign Body Ingestion in Children
Yi Chen1, Qingjiang Chen1, Yunzhong Qian1
1Department of General Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.
Insights
Multiple magnetic foreign body ingestion in children is increasing, causing serious gastrointestinal injury. Early detection and tailored treatment are crucial for minimizing harm from these pediatric foreign body ingestions.
Area of Science:
- Pediatric Gastroenterology
- Pediatric Surgery
- Medical Device Safety
Background:
- Rising incidence of pediatric multiple magnetic foreign body (MMFB) ingestion poses significant gastrointestinal injury risks.
- Need for enhanced awareness among parents and caregivers regarding MMFB ingestion dangers.
- Importance of analyzing clinical characteristics and treatment experiences for optimal management.
Purpose of the Study:
- Analyze clinical characteristics of pediatric MMFB ingestion.
- Summarize and discuss treatment experiences.
- Identify optimal treatment plans for MMFB ingestion in children.
Main Methods:
- Retrospective analysis of 130 pediatric patients with MMFB ingestion (June 2016 - June 2023).
- Systematic collection of clinical data, treatment details, and patient prognosis.
- Comparison of conservative management, open surgery, and laparoscopic surgery outcomes.
Main Results:
- 41 patients managed conservatively, 89 underwent open surgery; 28/44 laparoscopic surgeries required conversion to laparotomy.
- Symptomatic children had a significantly higher risk of gastrointestinal perforation (P < .001), mainly in the small intestine.
- Successful laparoscopic surgery had a median hospital stay of 10 days, compared to 12 days for conversions to laparotomy (P < .05).
Conclusions:
- MMFB ingestion in children can cause severe injuries, highlighting the need for early detection and prompt treatment.
- Individualized clinical management strategies are essential for minimizing harm.
- A comprehensive framework for individualized treatment processes is proposed for pediatric MMFB ingestion.
Abstract:
The incidence of multiple magnetic foreign body (MMFB) ingestion in children is rising, which poses a serious risk for gastrointestinal tract injury. In the current study, the clinical characteristics were analyzed to enhance awareness among parents and caregivers, treatment experiences were summarized and discussed, and optimal treatment plans were identified. A retrospective analysis was performed on 130 pediatric patients with MMFB ingestion at the Children's Hospital Affiliated with Zhejiang University School of Medicine, between June 2016 and June 2023. The clinical data, treatment details, and patient prognosis were systematically collected. Forty-one patients were managed conservatively, while 89 patients underwent open surgery. Among the 44 patients who were treated with laparoscopic surgery, conversion to laparotomy was necessary in 28. The risk of gastrointestinal perforation was higher in symptomatic children than in asymptomatic children (chi-square value: 37.156; P < .001). Perforations were mainly observed in the small intestine. The median length of hospital stay was 10 days in the cohort of 16 children who underwent laparoscopic surgery successfully, which differed from the group of 28 children who were converted to a laparotomy (10 days [interquartile range, or IQR: 9-12.75 days] versus 12 days [IQR: 10-15.75 days]; P < .05). The ingestion of MMFBs in children can lead to severe injuries, underscoring the importance of early detection and treatment. Tailored clinical management strategies should be implemented based on individual conditions, while prompt and effective interventions can minimize harm. Therefore, we propose a comprehensive framework for individualized treatment processes.
