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DOI: 10.1055/s-2008-1039192
© Georg Thieme Verlag KG Stuttgart · New York
Intestinal Complications of Magnet Ingestion in Children from the Pediatric Surgery Perspective
Publikationsverlauf
Publikationsdatum:
17. Februar 2009 (online)
![](https://www.thieme-connect.de/media/ejps/200905/lookinside/thumbnails/10.1055-s-2008-1039192-1.jpg)
Introduction
Ingestion of foreign bodies is not an uncommon clinical scenario seen by the emergency medicine physician, pediatrician, or pediatric surgeon. Often, ingested foreign bodies beyond the esophagus are treated conservatively without intervention. However, the ingestion of magnets poses an underappreciated and potentially hazardous clinical risk. Allowing magnets to pass naturally may be fraught with morbidity which may lead to extensive surgical intervention.
We present the case of a two-year-old child in whom ingestion of multiple magnets led to the formation of a small bowel fistula leading to internal herniation and small bowel obstruction. We discuss the literature together with the diagnosis and management of ingestion of multiple magnets.
References
- 1 Ahern J L. Solid earth geophysics; basics of magnetics. 2004; Available at: http://geophysics.ou.edu/solid_earth/notes/mag_basic/mag_basic.html Dec.16.2008
- 2 Akita H, Hikita H, Ymanouchi E. et al . Use of a metallic-wall stent in the magnet compression anastomosis technique for bile duct obstruction after liver transplantation. Liver Transpl. 2008; 14 118-120
- 3 Alzahem A M, Soundappan S S, Jefferies H. et al . Ingested magnets and gastrointestinal complications. J Paediatr Child Health. 2007; 43 497-498
- 4 Anselmi E H, San Roman C G, Fontoba J EB. et al . Intestinal perforation caused by magnetic toys. J Pediatr Surg. 2007; 42 e13-16
- 5 Butterworth J, Feltis B. Toy magnet ingestion in children: revising the algorithm. J Pediatr Surg. 2007; 42 e3-e5
- 6 Cauchi J A, Shawis R N. Multiple magnet ingestion and gastrointestinal morbidity. Arch Dis Child. 2002; 87 539-540
- 7 Centers for Disease Control and Prevention . Gastrointestinal injuries from magnet ingestion in children – United States, 2003–2006. MMWR Morb Mortal Wkly. 2006; 55 1296-1300
- 8 Chung J H, Kim J S, Son Y T. Small bowel complication caused by magnetic foreign body ingestion of children: two case reports. J Pediatr Surg. 2003; 38 1548-1550
- 9 Cope C. Evaluation of compression cholecystogastric and cholecystojejunal anastomoses in swine after peroral and surgical introduction of magnets. J Vasc Interv Radiol. 1995; 6 546-552
- 10 Erdmann D, Sweis R, Heitmann C. et al . Side-to-side sutureless vascular anastomosis with magnets. J Vasc Surg. 2004; 40 505-511
- 11 Fenton S J, Torgenson M, Holsti M. et al . Magnetic attraction leading to a small bowel obstruction in a child. Pediatr Surg Int. 2007; 23 1245-1247
- 12 Haraguchi M, Matsuo S, Tokail H. et al . Surgical intervention for the ingestion of multiple magnets by children. J Clin Gastroenterol. 2004; 38 915-916
- 13 Heitmann C, Khan F N, Erdmann D. et al . Vein graft anastomoses with magnets. J Plast Reconstr Aesthet Surg. 2007; 60 1296-1301
- 14 Honzumi M, Shigemori C, Ito H. et al . An intestinal fistula in a 3-year-old child caused by the ingestion of magnets: report of case. Surg Today. 1995; 25 552-553
- 15 Ilce Z, Samsum H, Mammadov E. et al . Intestinal volvulus and perforation caused by multiple magnet ingestion: report of a case. Surg Today. 2007; 37 50-52
- 16 Jansen A, Brummelkanp W H, Davis G A. et al . Clinical applications of magnetic rings in colorectal anastomosis. Surg Gynecol Obstet. 1981; 153 537-545
- 17 Kircher M F, Milla S, Callahan M J. Ingestion of magnetic foreign bodies causing multiple bowel perforations. Pediatr Radiol. 2007; 37 933-936
- 18 Kubota Y, Tokiwa K, Tanaka S. et al . Intestinal obstruction in an infant due to magnet ingestion. Eur J Pediatr Surg. 1995; 5 119-120
- 19 Lee S, Beck N, Kim H. Mischievous magnets: unexpected health hazard in children. J Pediatr Surg. 1996; 31 1694-1695
- 20 Liu S, Blacam C, Lim F. et al . Magnetic foreign body ingestions leading to duodenocolonic fistula. J Pediatr Gastroenterol Nutr. 2005; 41 670-672
- 21 Magnet Sales and Manufacturing Inc. 2000; Available at: http://www.magnetsales.com . Dec.16.2008
- 22 McCormick S, Brennan P, Yassa J. et al . Children and mini-magnets: an almost fatal attraction. Emerg Med J. 2002; 19 71-73
- 23 Nagaraj H S, Sunil I. Multiple foreign body ingestion and ileal perforation. Pediatr Surg Int. 2005; 21 718-720
- 24 Nui A, Hirama T, Katsuramaki T. et al . An intestinal volvulus caused by multiple magnet ingestion: an unexpected risk in children. J Pediatr Surg. 2005; 40 e9-e11
- 25 Oestreich A E. Multiple magnet ingestion alert. Radiology. 2004; 23 615
- 26 Oestreich A E. Danger of multiple magnets beyond the stomach in children. J Natl Med Assoc. 2006; 98 277-279
- 27 Ohno Y, Yoneda A, Enjoji A. et al . Gastroduodenal fistula caused by ingested magnets. Gastrointest Endosc. 2005; 61 109-110
- 28 Okajima H, Kotera A, Takeichi T. et al . Magnet compression anastomosis for bile duct stenosis after duct-to-duct biliary reconstruction in living donor liver transplantation. Liver Transpl. 2005; 11 473-475
- 29 Pryor H I, Lange P A, Bader A. et al . Multiple magnetic foreign body ingestion: a surgical problem. J Am Coll Surg. 2007; 205 182-186
- 30 Takao S, Matsuo Y, Shinchi H. et al . Magnetic compression anastomosis for benign obstruction of the common bile duct. Endoscopy. 2001; 33 988-990
- 31 Tay E T, Weinberg G, Levin T L. Ingested magnets: the force within. Pediatr Emerg Care. 2004; 20 466-467
- 32 Uchida K, Otake K, Iwata T. et al . Ingestion of multiple magnets: hazardous foreign bodies for children. Pediatr Radiol. 2006; 36 263-264
- 33 Vijaysadan V, Perez M, Kuo D. Revisiting swallowed troubles: intestinal complications caused by two magnets – a case report, review and proposed revision to the algorithm for the management of foreign body ingestion. J Am Board Fam Med. 2006; 19 511-516
- 34 Wildhaber B E, Le Coultre C, Genin B. Ingestion of magnets: innocent in solitude, harmful in groups. J Pediatr Surg. 2005; 40 e33-e35
Dr. Kuojen Tsao
Department of Pediatric Surgery
University of Texas Medical School at Houston
6431 Fannin Street MSB5.254
Houston, TX 77030
USA
eMail: kuojen.tsao@uth.tmc.edu