Magnet Ingestion

Abstract

A 6-year-old boy presented to the emergency room with a 3-week history of abdominal pain described as colicky and diffuse. He admitted that he had eaten several magnetic toys before the occurrence of symptoms. An abdominal flat plate revealed multiple radio-opaque objects throughout the abdomen (Figure 1). The patient underwent emergency exploratory laparotomy, which revealed a volvulus of the small bowel and four jejunal enterotomies caused by pressure necrosis of attaching magnets (Figure 2). In total, 11 1.5-cm magnetic toy bars and 7 ball bearings were removed through the jejunal enterotomies and a surgically indicated cecal colostomy (Figure 3).Figure 2Spontaneous enterotomy from pressure necrosis (arrow).View Large Image Figure ViewerDownload Hi-res image Download (PPT)Figure 3Removed magnetic objects.View Large Image Figure ViewerDownload Hi-res image Download (PPT)Significant morbidity and even mortality have been associated with magnet ingestion in children due to magnetic attraction, which can lead to volvulus, perforation, and fistula formation.1Centers for Disease Control and PreventionGastrointestinal injuries from magnet ingestion in children, United States, 2003-2006.MMWR Morb Mortal Wkly Rep. 2006; 55: 1296-1300PubMed Google Scholar, 2Cauchi J.A. Shawis R.N. Multiple magnet ingestion and gastrointestinal morbidity.Arch Dis Child. 2002; 87: 539-540Crossref PubMed Scopus (81) Google Scholar Early surgical intervention is essential in any child with a history of ingesting multiple magnets, especially in the presence of abdominal pain.3Uchida K. Otake K. Iwata T. Watanabe H. Inoue M. Hatada T. et al.Ingestion of multiple magnets: hazardous foreign bodies for children.Pediatr Radiol. 2006; 36: 263-264Crossref PubMed Scopus (24) Google Scholar Surgical intervention also likely will be necessary in any child who has ingested a magnet along with other metallic objects, which can lead to magnetic attraction and bowel perforation.Underlying psychosocial, psychiatric, and developmental risk factors have been noted in many children with a history of foreign body ingestion, and such risk factors should be screened for at presentation.4Binder L. Anderson W. Pediatric gastrointestinal foreign body ingestions.Ann Emerg Med. 1984; 13: 112-117Abstract Full Text PDF PubMed Scopus (86) Google Scholar In addition, clinicians should make patients and their families aware of the risks associated with ingesting multiple magnets or magnets along with metallic objects.5Lee S. Beck N. Kim H. Mischievous magnets: unexpected health hazard in children.J Pediatr Surg. 1996; 31: 1694-1695Abstract Full Text PDF PubMed Scopus (59) Google Scholar This patient had no history of psychiatric disorder, and he and his parents were counseled regarding the dangers of magnet ingestion.References available atwww.jpeds.com. A 6-year-old boy presented to the emergency room with a 3-week history of abdominal pain described as colicky and diffuse. He admitted that he had eaten several magnetic toys before the occurrence of symptoms. An abdominal flat plate revealed multiple radio-opaque objects throughout the abdomen (Figure 1). The patient underwent emergency exploratory laparotomy, which revealed a volvulus of the small bowel and four jejunal enterotomies caused by pressure necrosis of attaching magnets (Figure 2). In total, 11 1.5-cm magnetic toy bars and 7 ball bearings were removed through the jejunal enterotomies and a surgically indicated cecal colostomy (Figure 3). Significant morbidity and even mortality have been associated with magnet ingestion in children due to magnetic attraction, which can lead to volvulus, perforation, and fistula formation.1Centers for Disease Control and PreventionGastrointestinal injuries from magnet ingestion in children, United States, 2003-2006.MMWR Morb Mortal Wkly Rep. 2006; 55: 1296-1300PubMed Google Scholar, 2Cauchi J.A. Shawis R.N. Multiple magnet ingestion and gastrointestinal morbidity.Arch Dis Child. 2002; 87: 539-540Crossref PubMed Scopus (81) Google Scholar Early surgical intervention is essential in any child with a history of ingesting multiple magnets, especially in the presence of abdominal pain.3Uchida K. Otake K. Iwata T. Watanabe H. Inoue M. Hatada T. et al.Ingestion of multiple magnets: hazardous foreign bodies for children.Pediatr Radiol. 2006; 36: 263-264Crossref PubMed Scopus (24) Google Scholar Surgical intervention also likely will be necessary in any child who has ingested a magnet along with other metallic objects, which can lead to magnetic attraction and bowel perforation. Underlying psychosocial, psychiatric, and developmental risk factors have been noted in many children with a history of foreign body ingestion, and such risk factors should be screened for at presentation.4Binder L. Anderson W. Pediatric gastrointestinal foreign body ingestions.Ann Emerg Med. 1984; 13: 112-117Abstract Full Text PDF PubMed Scopus (86) Google Scholar In addition, clinicians should make patients and their families aware of the risks associated with ingesting multiple magnets or magnets along with metallic objects.5Lee S. Beck N. Kim H. Mischievous magnets: unexpected health hazard in children.J Pediatr Surg. 1996; 31: 1694-1695Abstract Full Text PDF PubMed Scopus (59) Google Scholar This patient had no history of psychiatric disorder, and he and his parents were counseled regarding the dangers of magnet ingestion. References available atwww.jpeds.com.