Forum

The risks of gastrointestinal injury due to ingested magnetic beads

Sharon Cox, Robin Brown, Alastair Millar, Alp Numanoglu, Angus Alexander, Andre Theron

Abstract


Accidental ingestion of foreign bodies is a common problem in children. Magnetic bead toys are hazardous, having potentially lethal consequences if ingested. These magnets conglomerate in different segments of bowel, causing pressure necrosis, perforation and/or fistula formation anywhere along the gastrointestinal tract. A clinical diagnostic pitfall is that the appearance on the initial abdominal radiograph may be misinterpreted by the uninitiated as a single metallic object without any intervening intestinal wall. Symptoms do not occur until complications have developed, and even then, unless magnet ingestion is suspected, treatment may initially be mistakenly expectant, as with any other foreign body. After observing a case of multiple magnet ingestion that led to the rapid onset of small-bowel inter-loop fistulas and peritonitis, we attempted to reproduce the likely sequence of events in a laboratory setting using fresh, post-mortem porcine bowel as an animal model and placing magnetic toy beads within the bowel lumen. Pressure-induced perforation appeared extremely rapidly, replicating the operative findings in two of our cases. We propose that if magnet ingestion is suspected, early endoscopic or surgical retrieval is mandatory. Appropriate, rapid surgical intervention is indicated. Laparoscopy offers a minimally invasive therapeutic option. 


Authors' affiliations

Sharon Cox, Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital; University of Cape Town, South Africa

Robin Brown, Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital; University of Cape Town, South Africa

Alastair Millar, Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital; University of Cape Town, South Africa

Alp Numanoglu, Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital; University of Cape Town, South Africa

Angus Alexander, Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital and University of Cape Town, South Africa

Andre Theron, Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital; University of Cape Town, South Africa

Full Text

PDF (639KB)

Keywords

ingested magnetic beads; gastrointestinal injury

Cite this article

South African Medical Journal 2014;104(4):277-278. DOI:10.7196/SAMJ.7500

Article History

Date submitted: 2013-09-13
Date published: 2014-01-20

Article Views

Abstract views: 2719
Full text views: 993

Comments on this article

*Read our policy for posting comments here