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Abstract
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Ingestion of a foreign body, whether inadvertent or intentional, is a common clinical problem. The American Association of Poison Control Centers reported over 100,000 incidents of ingestion of foreign bodies by children and adolescents in the year 2000. The vast majority of ingestions are accidental, with the peak incidence in children occurring between six months and three years of age. Intentional ingestions occur with increasing frequency in the adolescent years. In the United States, the most commonly ingested for- eign bodies are coins, followed by myriad other objects including toys, toy parts, jewelry, batteries, and a wide variety of small objects such as house keys and dental appliances. Even a toothbrush has been accidentally ingested by a bulimic patient.
The majority of ingested objects pass through the ali- mentary tract without complications. Intervention is required in certain circumstances, however, such as when a coin lodges in the esophagus, or an object that con- tains potentially toxic material such as lead or a battery. Occasionally, an esophageal foreign body is identified on a chest x-ray in a child who is undergoing evaluation of wheezing or other respiratory problem.
As discussed further below, however, ingested magnets pose unique challenges. Building sets and toys are commonly manufactured for children with powerful rare earth magnets (commonly neodymium iron boron or samarium cobalt magnets). Their small size increases their potential for ingestion by children who commonly put objects in their mouths. In many toys the magnets are embedded in plastic parts and can be easily detached. In Asian countries magnetic beads and necklaces are worn for their purported healing power. In the United States, the use of magnets is frequently described in the literature on complementary and alternative medicine.
The hazards of ingested magnets
The following case is presented to alert the reader to the unique risks inherent in this apparently benign occurrence, and to outline an approach that emphasizes early and aggressive intervention to prevent significant morbidity and possibly mortality.
Case Report A 7-year-old child was brought to the emergency room by his grandmother with a chief complaint of abdominal pain. The pain was of sudden onset, and occurred while the child was playing a computer game. When asked where the pain was most severe, the child pointed to the upper abdomen. There was no vomiting or diarrhea. There was no history of fever and the child had recently consumed a normal lunch. The child's past medical history included ADHD, for which he was taking Concerta, 18 mg once daily. There was no other significant past medical or surgical history...
Keywords: Multiple magnet ingestion
Language: en |