Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
권호 표지
DOI QR코드

DOI QR Code

Non-Surgical Management of Gastroduodenal Fistula Caused by Ingested Neodymium Magnets

  • Phen, Claudia (Office of Medical Education, Johns Hopkins All Children's Hospital) ;
  • Wilsey, Alexander (Office of Medical Education, Johns Hopkins All Children's Hospital) ;
  • Swan, Emily (College of Arts and Sciences, Florida State University) ;
  • Falconer, Victoria (College of Arts and Sciences, University of Florida) ;
  • Summers, Lisa (Pediatric Gastroenterology, Carolines Healthcare System) ;
  • Wilsey, Michael (Pediatric Gastroenterology, Johns Hopkins All Children's Hospital)
  • Received : 2017.08.04
  • Accepted : 2018.01.08
  • Published : 2018.10.15
Download PDF
⟨ Previous Next ⟩

Abstract

Foreign body ingestions pose a significant health risk in children. Neodymium magnets are high-powered, rare-earth magnets that is a serious issue in the pediatric population due to their strong magnetic force and high rate of complications. When multiple magnets are ingested, there is potential for morbidity and mortality, including gastrointestinal fistula formation, obstruction, bleeding, perforation, and death. Many cases require surgical intervention for removal of the magnets and management of subsequent complications. However, we report a case of multiple magnet ingestion in a 19-month-old child complicated by gastroduodenal fistula that was successfully treated by endoscopic removal and supportive care avoiding the need for surgical intervention. At two-week follow-up, the child was asymptomatic and upper gastrointestinal series obtained six months later demonstrated resolution of the fistula.

Keywords

References

  1. Oestreich AE. Worldwide survey of damage from swallowing multiple magnets. Pediatr Radiol 2009;39:142-7. https://doi.org/10.1007/s00247-008-1059-7
  2. Abbas MI, Oliva-Hemker M, Choi J, Lustik M, Gilger MA, Noel RA, et al. Magnet ingestions in children presenting to US emergency departments, 2002-2011. J Pediatr Gastroenterol Nutr 2013;57:18-22. https://doi.org/10.1097/MPG.0b013e3182952ee5
  3. Kramer RE, Lerner DG, Lin T, Manfredi M, Shah M, Stephen TC, et al.; North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Endoscopy Committee. Management of ingested foreign bodies in children: a clinical report of the NASPGHAN Endoscopy Committee. J Pediatr Gastroenterol Nutr 2015;60:562-74. https://doi.org/10.1097/MPG.0000000000000729
  4. Waters AM, Teitelbaum DH, Thorne V, Bousvaros A, Noel RA, Beierie EA. Surgical management and morbidity of pediatric magnet ingestions. J Surg Res 2015;199:137-40. https://doi.org/10.1016/j.jss.2015.04.007
  5. Dutta S, Barzin A. Multiple magnet ingestion as a source of severe gastrointestinal complications requiring surgical intervention. Arch Pediatr Adolesc Med 2008;162:123-5. https://doi.org/10.1001/archpediatrics.2007.35
  6. Bauman B, McEachron K, Goldman D, Louiselle A, Zheng E, Mills D, et al. Emergency management of the ingested magnet: an algorithmic approach. Pediatr Emerg Care 2017. doi: 10.1097/PEC.0000000000001168. [Epub ahead of print]
  7. Hwang J, Park M, Choi S, Park W, Kim AS. How strong construction toy magnets are! A gastro-gastro-duodenal fistula formation. J Pediatr Gastroenterol Nutr 2007; 44:291-2. https://doi.org/10.1097/MPG.0b013e31802c6e69
  8. Ohno Y, Yoneda A, Enjoji A, Furui J, Kanematsu T. Gastroduodenal fistula caused by ingested magnets. Gastrointest Endosc 2005;61:109-10. https://doi.org/10.1016/S0016-5107(04)02387-9
  9. Sugawa C, Ono H, Taleb M, Lucas C. Endoscopic management of foreign bodies in the upper gastrointestinal tract: a review. World J Gastrointest Endosc 2014;6: 475-81. https://doi.org/10.4253/wjge.v6.i10.475
  10. Tsai J, Shaul DB, Sydorak RM, Lau ST, Akmal Y, Rodriguez K. Ingestion of magnetic toys: report of serious complications requiring surgical intervention and a proposed management algorithm. Perm J 2013;17: 11-4. https://doi.org/10.7812/TPP/12-097

Cited by

  1. A Child With a Gastrocolic Fistula After Ingesting Magnets: An Unusual Complication vol.12, pp.7, 2018, https://doi.org/10.7759/cureus.9336
  2. A nationwide questionnaire survey on accidental magnet ingestion in children in Japan vol.110, pp.1, 2018, https://doi.org/10.1111/apa.15428
  3. Retrospective analysis of pediatric patients with multiple rare-earth magnets ingestion: a single-center experience from China vol.21, pp.1, 2018, https://doi.org/10.1186/s12887-021-02642-y