Abstract
Background
It is increasingly recognized that in children swallowed multiple magnets cause considerable damage to the gastrointestinal tract.
Objective
To emphasize that complications from swallowed magnets are extensive worldwide and throughout childhood.
Materials and methods
The author surveyed radiologists and researched cases of magnet swallowing in the literature and documented age and gender, numbers of magnets, nature of the magnets, reasons for swallowing, and clinical course.
Results
A total of 128 instances of magnet swallowing were identified, one fatal. Cases from 21 countries were found. Magnet swallowing occurred throughout childhood, with most children older than 3 years of age. Numbers of swallowed magnets ranged up to 100. Twelve children were known to be autistic. Many reasons were given for swallowing magnets, and a wide range of gastrointestinal damage was encountered. Considerable delay before seeking medical assistance was frequent, as was delay before obtaining radiographs or US imaging.
Conclusion
Damage from swallowing multiple magnets is a considerable worldwide problem. More educational and preventative measures are needed.
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Acknowledgements
I thank all colleagues, both medical and in other professions (such as reporters, lawyers, and government workers), who contributed material to this survey.
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Addendum: Postgastric Magnetopathy Survey (as distributed to colleagues worldwide)
Addendum: Postgastric Magnetopathy Survey (as distributed to colleagues worldwide)
Dear Colleagues,
Many dozens of postgastric magnetopathy case reports have appeared in the medical literature throughout the world. These are children who have swallowed multiple magnets from toys, jewelry, home remedies, industrial uses, and perhaps other sources. These magnets often (I believe usually) attract each other across bowel walls, especially once they are beyond the stomach. Many abdominal complications have been found surgically (or occasionally endoscopically), often severe, despite relatively mild clinical symptoms, which often have delayed seeking medical help and then delayed radiographing or ultrasound imaging. One death, from the USA state of Washington, is known.
For a brief forum to be held during the ESPR meeting in Scotland this June, I would greatly appreciate input in regard to patients encountered with this problem. In addition to real-time audience discussion, I request information in advance by e-mail. To make the tabulations non-redundant, please provide some identifying data (but not patient name!)
My questions:
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1.
Your name and city/country and hospital/institution/praxis; and e-mail address (for me personally, not to be published)
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2.
Have you or your colleagues encountered children (or former children) who have swallowed multiple magnets?
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3.
Please list any patients involved by age at time of diagnosis, gender, and city/country where encountered.
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4.
What was swallowed specifically? How many? Brand name? Did patient or parent state WHY they were swallowed?
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5.
How was diagnosis made?
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6.
What were the known symptoms? How long a delay before seeking medical attention? How long a delay from seeking medical attention until diagnosis was made? What manner of imaging led to the diagnosis?
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7.
What damage was encountered in the abdomen (or elsewhere in body)?
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8.
Outcome or follow-up?
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9.
Was the child autistic?
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10.
If case(s) were published could you provide reference, please? Or was it presented at a congress or meeting?
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11.
Further comments?
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12.
I have reviewed many published articles (in English, German, and Spanish at least) but I would greatly appreciate any references from the world literature that you could quote to me (beyond your own cases).
Many thanks in advance.
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Oestreich, A.E. Worldwide survey of damage from swallowing multiple magnets. Pediatr Radiol 39, 142–147 (2009). https://doi.org/10.1007/s00247-008-1059-7
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DOI: https://doi.org/10.1007/s00247-008-1059-7