Magnets

Pediatric Pearls: Magnet Ingestion EMRAP January 2021

Ilene Claudius, MD, Solomon Behar, MD, Matthew Strickland, MD and Daniel Rosenfield, MD

• Magnets developed in the last decade are widely available in childrens’ toys as well as “desk” toys.
• A history of magnet ingestion may or may not be present.
• Ingestions typically occur in multiple forms
  • Single magnet isolated in time (least concerning)
  • Multiple magnets or a single magnet and a metallic foreign body (most concerning)
• If multiple magnets are ingested the clinical concern is that these can link up through loops of the GI tract which would arrest their distal movement and cause mural pressure and necrosis.
• Management
  • Plain abdominal X-rays are the first step to assess whether a magnet (or magnets) are present.
  • In single magnet ingestion, these can be followed with serial x-rays on an outpatient basis.
  • In multiple magnetingestion:
    • If all magnets are within the stomach or esophagus, they should be removed by endoscopy.
    • If all magnets are beyondthe stomach, specialty consultation with either pediatric gastroenterology and/or pediatric surgery is indicated.
      • Advanced imaging and serial exams may be necessary.
      • Endoscopy or colonoscopy for removal may be attempted depending on location.
    • Strickland M., et al. Case Discussions and Radiographic Illustration of Magnet-Related Injuries in Children. J Emerg Med 2020 Jun;58(6):902-909.