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      Rare-Earth Magnet Ingestion–Related Injuries in the Pediatric Population: A Review

      1 , 2 , 3 , 1 , 2 , 3 , 1 , 2 , 3
      American Journal of Lifestyle Medicine
      SAGE Publications

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          Abstract

          <p class="first" id="d8432361e133">Foreign-body ingestions are common among children and usually resolve with limited, if any, treatment. The ingestion of rare-earth magnets, however, commonly results in serious injury or death. These dangerous high-powered magnets can be found in the United States in a variety of consumer products, including magnetic toy sets designed for children and adults. The ingestion of one of such magnet is unlikely to cause significant harm. However, if multiple magnets are ingested, or if a magnet is ingested along with a metal object, the magnets are powerful enough to attract each other through the walls of the intestine, potentially resulting in significant internal damage. Rare-earth magnet ingestion cases are difficult to diagnose and the symptoms are not easy to differentiate from other causes of gastrointestinal illness or pain. However, delays in medical treatment can lead to serious injury or death. This review article describes the epidemiology of rare-earth magnet ingestion-related injuries and provides recommendations for diagnosis and treatment. Federal regulatory efforts related to rare-earth magnets and other prevention strategies are also discussed. </p>

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          Most cited references13

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          Pediatric foreign bodies and their management.

          Ingestion of foreign bodies is a common pediatric problem, with more than 100,000 cases occurring each year. The vast majority of pediatric ingestions are accidental; increasing incidence of intentional ingestions starts in the adolescent age group. In the United States, the most common pediatric foreign bodies ingested are coins, followed by a variety of other objects, including toys, toy parts, sharp objects, batteries, bones, and food. In adolescents and adults, meat or food impactions are the most common accidental foreign body ingestion. Esophageal pathology underlies most cases of food impaction. Management of foreign body ingestions varies based on the object ingested, its location, and the patient's age and size. Esophageal foreign bodies as a group require early intervention because of their potential to cause respiratory symptoms and complications, esophageal erosions, or even an aortoesophageal fistula. Ingested batteries that lodge in the esophagus require urgent endoscopic removal even in the asymptomatic patient due to the high risk of complications. Sharp foreign bodies increase the foreign body complication rate from less than 1% to 15% to 35%, except for straight pins, which usually follow a relatively benign course unless multiple pins are ingested. Magnets are increasingly ingested, due to their ubiquitous nature and the perception that they do not pose a risk. Ingestion of multiple magnets creates a significant risk of obstruction, perforation, and fistula development. Methods to deal with foreign bodies include the suture technique, the double snare technique, and the combined forceps/snare technique for long, large, and sharp foreign bodies, along with newer equipment, such as retrieval nets and a variety of specialized forceps.
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            Management of ingested magnets in children.

            We describe a comprehensive algorithm for the management of ingested rare-earth magnets in children. These newer and smaller neodymium magnets sold as adult toys are much stronger than the traditional magnets, and can attract each other with formidable forces. If >1 magnet is swallowed at the same time, or a magnet is co-ingested with another metallic object, the loops of intestine can be squeezed between them resulting in bowel damage including perforations. An algorithm that uses the number of magnets ingested, location of magnets, and the timing of ingestion before intervention helps to delineate the roles of the pediatric gastroenterologists and surgeons in the management of these cases.
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              Magnet ingestions in children presenting to US emergency departments, 2002-2011.

              In the last 10 years, there have been an increasing number of case reports concerning gastrointestinal injury related to magnet ingestions; however, the magnitude of the problem remains to be clearly defined. The aim of the study was to examine the epidemiology of magnet ingestion-related emergency department (ED) visits among children in the United States.
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                Author and article information

                Journal
                American Journal of Lifestyle Medicine
                American Journal of Lifestyle Medicine
                SAGE Publications
                1559-8276
                1559-8284
                February 16 2016
                May 2017
                July 22 2015
                May 2017
                : 11
                : 3
                : 259-263
                Affiliations
                [1 ]Center for Injury Research and Policy, Nationwide Children’s Hospital, Columbus, Ohio (NLH, SAD, GAS)
                [2 ]Section of Emergency Medicine, Nationwide Children’s Hospital, Columbus, Ohio (SAD, GAS)
                [3 ]Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio (SAD, GAS)
                Article
                10.1177/1559827615594336
                6125079
                30202341
                47d81c75-bae6-41d9-9b77-d2100052d069
                © 2017

                http://journals.sagepub.com/page/policies/text-and-data-mining-license

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