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Quezada H, Levine AE, Dellinger M, Rice-Townsend S, Zheng HB. Esophagogastric Fistula: The Consequence of High-Powered Magnets Ingestion. JPGN REPORTS 2023; 4:e385. [PMID: 38034440 PMCID: PMC10684210 DOI: 10.1097/pg9.0000000000000385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/02/2023] [Indexed: 12/02/2023]
Abstract
A 17-month-old female had an unwitnessed ingestion of 26 high-powered magnets, resulting in the creation of an esophagogastric fistula via the left crus of the diaphragm. This case highlights a rare injury to the stomach and esophagus caused by high-powered magnets requiring surgical intervention. Furthermore, this case report illustrates the risks that high-powered magnets pose to young children. Additionally, this case highlights the importance of maintaining a high level of suspicion for ingestion in young patients along with a multidisciplinary team to manage sequelae of injury.
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Affiliation(s)
- Hugo Quezada
- From the Department of Pediatrics, University of Washington School of Medicine, Seattle, WA
- Department of Pediatrics, Seattle Children’s Hospital, Seattle, WA
| | - Anne E. Levine
- From the Department of Pediatrics, University of Washington School of Medicine, Seattle, WA
- Division of Gastroenterology and Hepatology, Seattle Children’s Hospital, Seattle, WA
| | - Matthew Dellinger
- Department of Surgery, University of Washington, Seattle, WA
- Division of Pediatric General Surgery, Seattle Children’s Hospital, Seattle, WA
| | - Samuel Rice-Townsend
- Department of Surgery, University of Washington, Seattle, WA
- Division of Pediatric General Surgery, Seattle Children’s Hospital, Seattle, WA
| | - Hengqi Betty Zheng
- From the Department of Pediatrics, University of Washington School of Medicine, Seattle, WA
- Division of Gastroenterology and Hepatology, Seattle Children’s Hospital, Seattle, WA
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Nugud AA, Tzivinikos C, Assa A, Borrelli O, Broekaert I, Martin-de-Carpi J, Deganello Saccomani M, Dolinsek J, Homan M, Mas E, Miele E, Thomson M, Benninga MA. Pediatric Magnet Ingestion, Diagnosis, Management, and Prevention: A European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) Position Paper. J Pediatr Gastroenterol Nutr 2023; 76:523-532. [PMID: 36947000 DOI: 10.1097/mpg.0000000000003702] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Magnet ingestion is a special category of foreign body ingestion associated with high levels of morbidity and mortality worldwide, particularly if it is associated with staggered ingestion of multiple magnets or with simultaneous ingestion of other metallic foreign bodies, especially button batteries. A special category of magnet ingestion is the ingestion of earth magnets, which have higher levels of magnetism and therefore, potentially, carries a worse outcome. Legislative bodies, scientific Societies and community-led initiatives have been implemented worldwide with the aim of mitigating the effects of this growing, yet avoidable potential medical emergency. A scoping literature review summarized epidemiology, diagnosis, management, and prevention, including an algorithm for the diagnosis and management of magnet ingestion is presented and compared to previously published reviews and position papers (North American Society of Pediatric Gastroenterology, Hepatology and Nutrition, National Poison Center, Royal College of Emergency Medicine). The main emphasis of the algorithm is on identification of staggered/multiple magnet ingestion, and early joint gastroenterology and surgical consultation and management.
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Affiliation(s)
- A A Nugud
- From the Paediatric Gastroenterology Department, Al Jalila Children's Specialty Hospital, Dubai, United Arab Emirates
- Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Christos Tzivinikos
- From the Paediatric Gastroenterology Department, Al Jalila Children's Specialty Hospital, Dubai, United Arab Emirates
- Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Amit Assa
- The Juliet Keidan Institute of Pediatric Gastroenterology, Nutrition, Shaare Zedek Medical Center, The Hebrew University, Jerusalem, Israel
| | - Osvaldo Borrelli
- the Division of Neurogastroenterology & Motility, Department of Paediatric Gastroenterology, Great Ormond Street Hospital, London, UK
| | - Ilse Broekaert
- the Department of Paediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | | | | | - Jernej Dolinsek
- the Department of Pediatrics, University Medical Center Maribor, Maribor, Slovenia
| | - M Homan
- the Faculty of Medicine, University Children's Hospital, University of Ljubljana, Ljubljana, Slovenia
| | - Emmanuel Mas
- Service de Gastroentérologie, Hépatologie, Nutrition et Maladies Héréditaires du Métabolisme, Hôpital des Enfants, and IRSD, Université de Toulouse, INSERM, INRAE, ENVT, UPS, Toulouse, France
| | - Erasmo Miele
- the Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Naples, Italy
| | - Mike Thomson
- the Department of Paediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Marc A Benninga
- the Department of Paediatrics, Emma Children's Hospital, Amsterdam University Medical Center, Amsterdam, The Netherlands
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Demiroren K. Management of Gastrointestinal Foreign Bodies with Brief Review of the Guidelines. Pediatr Gastroenterol Hepatol Nutr 2023; 26:1-14. [PMID: 36816435 PMCID: PMC9911172 DOI: 10.5223/pghn.2023.26.1.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 07/09/2022] [Accepted: 08/30/2022] [Indexed: 01/15/2023] Open
Abstract
Foreign body (FB) ingestion is a common health problem that affects children more than adults. According to gastroenterologists' guidelines, the management of FB ingestion differs slightly between adult and children. This review aimed to compile adult and children guidelines and establish an understandable association to reveal the requirements and timing of the endoscopic procedure, which is the most effective and least complicated technique for gastrointestinal FBs. Coins, pins, and chicken and fish bones have been the most commonly ingested FBs. However, with their increasing use in recent years, large batteries with lithium-ion conversion, stronger magnets composed of rare earth metals, such as neodymium, and superabsorbent objects have become the most morbid and mortal, necessitating new management strategies. Although the approach to gastrointestinal FBs is controversial, with different treatment options available in different disciplines, many studies have demonstrated the efficacy and safety of endoscopic procedures. Many factors influence the timing of endoscopy, including the nature, size, and location of the ingested object and the patient's clinical condition.
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Affiliation(s)
- Kaan Demiroren
- Department of Pediatric Gastroenterology, University of Health Sciences, Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
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Arbeloa Miranda A, Samson F, Andina Martínez D, Ruiz Domínguez JA, Sáinz de la Maza VT, Azcúnaga Sanibañez B, Cadenas Benítez MN, Díaz Simal L, Lobato Salinas Z, Gilabert Iriondo N, López de Soria CO, Landa Maya JJ, Pérez Sáez MA, Romero-Hombrebueno Domínguez N, Casquero Cossio A. Multicentre study of magnet ingestion in Spanish paediatric emergency departments. An Pediatr (Barc) 2022; 97:310-316. [PMID: 36115782 DOI: 10.1016/j.anpede.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 04/22/2022] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION The ingestion of magnetic objects can cause complications in children, and there are no epidemiological or clinical data on the subject in Spain. OBJECTIVES To determine the incidence, epidemiological characteristics and management of magnet ingestion in paediatric emergency departments in Spain. MATERIAL AND METHODS Prospective observational multicentre study conducted over a 3-year period. The study universe consisted of patients aged less than 14 years. RESULTS The incidence was 4.8 cases per 100 000 emergency care episodes. Of the 72 patients included (mean age, 7.2 years), 54% were male. Seven percent had neuropsychiatric disorders. Sixty-one percent of the magnets were spherical and 69% came from toys. The size was variable, most frequently between 5 and 10 mm (50%), and ranging from 3 to 30 mm. Eighty-six percent of patients were asymptomatic. The most frequent symptom was abdominal pain. Eighty-three percent of the patients sought medical care within 6 h of ingestion and 92% within 24 h. Thirty-one percent of the cases were of multiple ingestion. Endoscopy was required for extraction in 15% of cases, a proportion that rose to 36% in the group of cases of multiple ingestion. None of the patients required surgery. We did not observe any gastrointestinal complications of magnet ingestion. CONCLUSIONS The ingestion of multiple magnets is less frequent than single magnet ingestion, and we did not observe any complications despite the lower frequency of procedures compared to other studies.
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Affiliation(s)
- Amaia Arbeloa Miranda
- Hospital Universitario Basurto, Sección de Urgencias de Pediatría, Bilbao, Bizkaia, Spain.
| | - Frederic Samson
- Hospital Universitario Basurto, Sección de Urgencias de Pediatría, Bilbao, Bizkaia, Spain
| | | | | | | | - Beatriz Azcúnaga Sanibañez
- Hospital Universitario Cruces, Universidad del País Vasco, Servicio de Urgencias de Pediatría, Barakaldo, Bizkaia, Spain
| | | | - Laura Díaz Simal
- Unidad/Área de Urgencias, Hospital Universitario Parc Taulí, Sabadell, Barcelona, Spain
| | | | | | | | | | - Maria Amalia Pérez Sáez
- Organización Sanitaria Integrada Goierri-Urola Garaia, Hospital de Zumárraga, Servicio de Pediatría, Zumárraga, Gipuzkoa, Spain
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Estudio multicéntrico de ingesta de imanes en los servicios de urgencias pediátricos españoles. An Pediatr (Barc) 2022. [DOI: 10.1016/j.anpedi.2022.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Ouyang H, You J, Dong T, Wu R, Liu L, Fan Z. A �push-and-pull� trick for endoscopic removal of Buckyballs impacted in the esophagus and gastric fundus. REVISTA ESPAÑOLA DE ENFERMEDADES DIGESTIVAS 2022; 115:275-276. [PMID: 36205322 DOI: 10.17235/reed.2022.9222/2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
As a common foreign body in children, magnet ingestion has been a widespread health issue. Unlike single magnet, ingestion of multiple magnets, especially those high-powered like Buckyballs could cause significant GI injury, e.g., perforation and fistula. Hereby we present a "push-and-pull" trick for management of a rare circumstance of Buckyballs ingestion.
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Miyamoto R, Okumura A. Response to a letter to the editor by Dong et al. Acta Paediatr 2021; 110:1968. [PMID: 33626188 DOI: 10.1111/apa.15817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 02/23/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Ryosuke Miyamoto
- Department of Pediatrics Aichi Medical University School of Medicine Nagakute Aichi Japan
| | - Akihisa Okumura
- Department of Pediatrics Aichi Medical University School of Medicine Nagakute Aichi Japan
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Dong T, Zhao L, Fan Z. Paediatric magnet ingestion: Urging for a national database. Acta Paediatr 2021; 110:1967. [PMID: 33629380 DOI: 10.1111/apa.15816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 02/23/2021] [Indexed: 01/31/2023]
Affiliation(s)
- Tao Dong
- Department of Digestive Endoscopy The First Affiliated Hospital with Nanjing Medical University Nanjing China
- Department of General Surgery The First Affiliated Hospital with Nanjing Medical University Nanjing China
| | - Lili Zhao
- Department of Digestive Endoscopy The First Affiliated Hospital with Nanjing Medical University Nanjing China
- Department of General Surgery The First Affiliated Hospital with Nanjing Medical University Nanjing China
| | - Zhining Fan
- Department of Digestive Endoscopy The First Affiliated Hospital with Nanjing Medical University Nanjing China
- Department of General Surgery The First Affiliated Hospital with Nanjing Medical University Nanjing China
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