Ingesting foreign objects is a relatively common cause of abdominal pain in children, but the ingestion of multiple magnets presents a unique and serious health risk. Imagine a seemingly innocent moment of play turning into a medical emergency. This was the reality for a young girl in Brazil who swallowed seven small ball magnets, leading to severe complications that required surgical intervention. Her story underscores the critical importance of awareness and prompt action when it comes to the dangers lurking in everyday items.
Dr. Daniel Tanure along with Dr. Laura Moreira and Dr. Renato Rebouças from Hospital São Vicente de Paulo, Dr. Jansen Tanure from The Federal University of Minas Gerais, and Professor Joao Rezende-Neto from the University of Toronto were involved in the study of this case. Their work was published in the International Journal of Surgery Case Reports. The girl presented with several days of abdominal pain, constipation, and reduced appetite, but no vomiting, fever, or peritoneal signs. Despite normal ultrasound results, further investigations revealed severe underlying issues.
Upon her admission to the hospital, the initial investigations included blood tests and abdominal radiographs. The blood tests revealed elevated white blood cell counts and C-reactive protein levels, indicating an inflammatory response. Abdominal radiographs showed a linear metallic foreign body in the small bowel and gas distension in the proximal gastrointestinal tract. These findings pointed to the presence of multiple magnets causing obstruction.
Given the serious nature of the symptoms and the initial findings, the medical team decided to proceed with a midline laparotomy. Dr. Tanure explained that this surgical approach was necessary to directly address the intestinal perforation and retrieve the magnets. During surgery, the team discovered that the magnets were connected in a linear configuration and caused a small perforation in the intestine. The magnets were removed, and the damaged section of the intestine was repaired through a meticulous process involving the resection of necrotic tissue and the suturing of the perforated area. “The magnets probably pinched the intestinal wall when attracting one another, leading to ischemia and perforation,” Dr. Tanure stated.
Significantly, the ingestion of multiple magnets increases the risk of serious complications such as volvulus, fistulas, and perforation, which can lead to peritonitis and potentially death if not treated promptly. The team noted that endoscopic removal of such foreign bodies is preferred when possible. However, in this case, the surgical route was necessary because the magnets had already passed from the stomach to the intestines. Initial non-invasive measures included inserting a nasogastric tube to decompress the stomach and administering laxatives to facilitate the passage of the magnets. However, when these measures proved insufficient, surgical intervention was required to prevent further complications.
Magnet ingestion is a growing concern, particularly in young children. A study in the US reported a significant number of cases over a decade, with most incidents involving children in this age group. Similarly, a Latin American study found that a notable fraction of endoscopies performed on children were due to magnet ingestion. These figures underscore the importance of preventive measures and parental awareness to avoid such dangerous incidents.
Dr. Tanure emphasized that parents and caregivers must be vigilant about the risks posed by magnetic toys and household items. “Awareness and education are crucial in preventing these incidents,” he noted. The team’s findings advocate for increased public health campaigns to inform about the dangers of magnet ingestion and the importance of timely medical intervention.
In conclusion, the ingestion of multiple magnets poses significant health risks in pediatric patients, necessitating swift and effective medical response. The detailed case report by Dr. Tanure and colleagues provides valuable insights into the clinical management of such cases, stressing the importance of awareness and preparedness among healthcare providers and caregivers alike.
Journal Reference
Tanure, D., Moreira, L., Tanure, J., Rezende-Neto, J., Rebouças, R. “Pediatric ingestion of multiple ball magnets leading to intestinal perforation: A case report.” International Journal of Surgery Case Reports, 2024. DOI: https://doi.org/10.1016/j.ijscr.2024.109505
About The Author
Dr. Daniel Tanure is a Family Medicine resident at McMaster University, Ontario, Canada. Dr. Tanure obtained his MD from Universidade Federal de Minas Gerais, in Belo Horizonte, Brazil, from 2013 to 2019. He worked in Brazil as an independent physician in the emergency department of Hospital Sao Vicente de Paulo de Aracuai, at the Special Immunobiologics Reference Centre of Belo Horizonte, and in the ICU of Hospital Eduardo de Menezes before starting his post-graduate training at McMaster. His major interest areas are Emergency Medicine, Medical Education, and Acute Care.
