Foreign body ingestion is commonly seen in children under 5 years. Most of these foreign bodies pass through the gastrointestinal tract unnoticed and without problems. However, ingestion of certain objects may cause significant harm. Coins and small toys for older children are often ingested and can be a problem when these got stuck in the esophagus. More recently, button batteries and neodymium magnets are being increasingly swallowed and can result in serious harm.
The 2020 British Association of Paediatric Surgeons winter campaign was focused on button batteries and the life-changing complications they can cause. Button batteries cause electrical currents and thermal necrosis, which can result in ulcers and perforations throughout the gastrointestinal tract.
Magnets have become more common in household toys also have the potential to cause serious injury as well.
In this report the experiences of four tertiary paediatric surgical centres are described. A rise in magnet ingestion was seen in these centers. Between January 2016 and December 2020, 251 children were admitted with foreign body ingestion. Coins were the most common foreign body ingested, followed by magnets and button batteries. There was a 56% increase in admissions for foreign object ingestion from 2016 to 2020. Most distressing is that a fivefold increase in the incidence of magnet ingestion was seen in the same time period and while only 2.4% of the ingested button batteries required surgery for retrieval, laparotomy or laparoscopic surgery was required for 42% of the patients with magnet ingestions. Ten children (4%) had surgical complications after retrieval of their foreign body and magnet ingestions accounted for 80% of all complications encountered, most of these severe.
The age limit suitability on most toys with magnets is usually quoted to be ≥14 years. However, the median age of patients ingesting magnets was 7 years (4 months to 16 years). While single magnets usually do not require any intervention, multiple magnets might attract each other from adjacent intestinal loops and entrap the intervening intestine, leading to necrosis and perforation.
The authors of this article, a group of paediatric surgeons, mention that they are extremely concerned with the recent rise in cases with magnet ingestions. It is a growing problem resulting in substantial morbidity. A public health campaign to increase awareness of the dangers of small, powerful magnets is called for.
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