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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front Med    0, Vol. Issue () : 280-287    https://doi.org/10.1007/s11684-012-0207-5
REVIEW
Gastrointestinal damage caused by swallowing multiple magnets
Shiqi Liu, Jianhui Li, Yi Lv()
Department of Hepatobiliary Surgery, the First Affiliated Hospital, Xi’an Jiaotong University, Xi’an 710061, China
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Abstract

Swallowing multiple magnets is not uncommon worldwide and it frequently leads to serious consequences. However, most patients fail to receive timely and correct diagnosis and treatment. A literature search was performed to establish an algorithm for these accidents by the authors to identify relevant articles published from June 1987 to October 2010 in Google, Medline, ISI Web of Knowledge Ovid, CNKI, Korea Med and library document delivery, using search terms “magnet ingestion, ” “fistula, ” and “perforation. ” A total of 149 patients with ingestion of magnetic foreign bodies from 20 countries and areas were identified. 22 of them were companioned with neurological and psychiatric disorders. Swallowing magnets occurred throughout childhood and adolescent, mostly ranging 2 to 4 years in age. Various gastrointestinal damages such as necrosis and intestinal perforation or fistula were encountered. Damage from swallowing multiple magnets carries a significant risk of morbidity and even mortality throughout childhood to adolescent worldwide. Older children and adults with neurological and psychiatric problems may be at high risk for such accidents. Early intervention is crucial.

Keywords magnet      ingestion      fistula      perforation     
Corresponding Author(s): Lv Yi,Email:luyi169@126.com   
Issue Date: 05 September 2012
 Cite this article:   
Shiqi Liu,Jianhui Li,Yi Lv. Gastrointestinal damage caused by swallowing multiple magnets[J]. Front Med, 0, (): 280-287.
 URL:  
https://academic.hep.com.cn/fmd/EN/10.1007/s11684-012-0207-5
https://academic.hep.com.cn/fmd/EN/Y0/V/I/280
Foreign bodyCases (n) and frequency (%)
Magnets130 (87.2)
Magnets with metallic elements10 (6.7)
Magnets with batteries4 (2.7)
Magnets with coins2 (1.34)
Miscellaneous2 (1.34)
Total149
Tab.1  Nature and frequency of foreign bodies ingested
Sources of magneticNumber (n) and frequency (%)Magnet quantity (piece)*Age (year) and median (range)Gender male no. (%)**
Toy parts66 (43.14)>3606 (10 months–13.5 years)38 (69.1)
Medical devices [2,11,1820]14 (9.15)>323 (10 months–7 years)7 (58.3)
Jewelry and ornaments [2,5,6,8,21,22]6 (3.92)>1414 (9–19)4 (66.7)
Other general industrial bodies9 (5.88)>3312 (1–48)9 (100)
Unknown58 (37.91)>2208 (2.5–15)29 (54.7)
Tab.2  The relationship between the sources and number of magnetic foreign bodies swallowed, patient’s age and gender
ReferenceAge (year)GenderNeurological and psychiatric symptomsResource
Midgett [13]4MaleAutismToy
Oestreich [22]4 years and 6 monthsMaleAutismToy
Midgett [13]5 years and 8 monthsMaleAttention deficit and hyperactivity disorderToy
Fenton [41]6MalePicaToy
Ohno [42]7FemaleParorexia, autisticToy
Liu [19]7MalePicaRemedies for muscle stiffness
Midgett [13]8 years and 2 monthsMaleDevelopment delayToy
Cauchi [43]9FemaleAutisticUnknown
Midgett [13]9 years and 4 monthsFemaleDevelopment delayToy
Brown [44]11MaleAttention deficit disorder presentedToy
Berg [35]11MaleSignificant for attention deficit and hyperactivity disorderToy
Midgett [13]11 years and 6 monthsMaleHyperactivity disorderToy
Lee [45]12MaleModerate mentally retardedToy
Hwang [36]12MaleAutismToy
Pryor [38]12MaleSignificant development delayToy
Oestreich [22]12 years and 6 monthsMaleAutismToy
Rashid [10]18MaleSevere parorexia, autisticA variety of metallic
Baliga [8]19FemaleMentally retardedBracelet shaped
Kirrane [7]22MaleSchizophreniaPurchased from a local hardware store
Kuzon [4]32MaleSchizoid-type personalityA large metallic and magnets and coin
Yoshifumi [9]44MaleAutismInstrument
Mok [20]48FemaleDelusionalPutative treatment for obesity
Tab.3  Patient companioned with neurological and psychiatric symptoms
Operating room findingsNumber (n) and frequency (%)OperatingEndoscopic
Esophagus [52,61]2 (1.34)11
Stomach [4,10,12,13,62]5 (3.36)41
Gastroduodenal fistula [24,42,45,63]4 (2.68)21
Esophagus, gastric and duodenal injury [52]1 (0.67)11
Stomach-intestine fistula [2,8,24,26,33,37,40]7 (4.70)53*
Stomach-duodenum-colon fistula [19,36]2 (1.34)22*
Stomach-intestine-colon injury [7,64]2 (1.34)1
Stomach-colon fistula [14,35]2 (1.34)2
Duodenum-jejunum fistula [9,20,44,65]4 (2.68)4
Duodenum-colonic fistula [36]1 (0.67)1
Jejunum-ileum fistula62 (41.61)62
Intestine-colon fistula [13,14,17,28,34,4851,53,55]14 (9.40)141*
Ileum-cecal perforation [16,58,66]9 (6.04)91*
Cecal injury [13,17]2 (1.34)2
Ileum-appendix-colon fistula [54]2 (1.34)2
No indicate the injury site30 (20.13)
Tab.4  Operating room findings and removal method
Fig.1  Treatment flow chart of magnetic foreign bodies.
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