ORLANDO -- The introduction of powerful magnetic "desk toys" such as Buckyballs for adults was associated with a spike in cases of magnet ingestion among children, and in many cases endoscopy and even surgery was needed to remove the foreign object and repair the damage that resulted, a researcher said here.
A small survey garnered data on 481 cases of magnet ingestion by children during a 10-year period up to 2012, with 320 cases being seen in the years immediately after neodymium magnets began being sold in 2008, according to Robert A. Noel, MD, of Louisiana State University in New Orleans.
Among the children who swallowed these magnets, 80% to 85% ended up having procedures that ranged from endoscopy to bowel resection, Noel reported in a pair of poster sessions at the annual Digestive Disease Week.
Most foreign bodies will pass through the gastrointestinal tract, and the same is true if a child swallows a single neodymium magnet.
"But if the kid swallows more than one of these magnets they'll find each other in the intestine, even from a distance, and pull toward each other, pinching off areas of tissue and cutting the blood supply," he explained.
"Deep ulcers can develop within hours, and after 12 hours you have a good chance of a perforation so early intervention is crucial," he said.
"During the spring of 2012, the bulletin board of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) showed an apparent increase in cases of magnet ingestion, so we decided to perform a survey to determine the extent of this," Noel said in an interview.
A total of 355 physicians from all around the U.S. and from several other countries responded to the survey.
Two-thirds of the affected children were boys, and the peak age was 3 to 6 years, with a second increase in incidence being seen at ages 9 to 12. This was notably different from the pattern seen with other types of foreign body ingestion, where the peak is between 1 and 2 years and falls thereafter.
"You never see that second peak in older kids with other types of foreign bodies except for in those who have psychiatric or developmental disorders," Noel told MedPage Today.
In fact, almost one-quarter of the ingestions were in older kids, who were using the magnets as "pretend" piercings in areas such as the tongue, and as imitation body art.
When used as imitation tongue piercings, the magnets can easily be swallowed, and in four cases they lodged in the appendix, he said.
In 123 of the cases, Noel was able to obtain details about treatment.
Serial x-rays were needed in 85% of cases, and 80% of the children had either endoscopy or surgery.
In 25% of cases requiring intervention, surgery was done, and in 43% of the surgical cases, removal of the magnets was followed by further procedures such as fistula repair or bowel resection.
The surgeries included laparotomy in 78%, laparoscopy in 19%, and thoracotomy in 3%.
And while most of the surgeries were successful, 1 in 10 of the children needed additional treatment.
Advocacy efforts on the part of NASPGHAN have now led to the removal of most of these desk magnet toys from the market through actions of the Consumer Product Safety Commission, Noel noted.
The authors had no disclosures.
- Reviewed by F. Perry Wilson, MD, MSCE Instructor of Medicine, Perelman School of Medicine at the University of Pennsylvania and Dorothy Caputo, MA, BSN, RN, Nurse Planner
Digestive Disease WeekSource Reference: Noel R, et al "Neodymium magnet adult desk toys are associated with increased medical and surgical intervention in children" DDW 2013; Abstract Sa1544.
Digestive Disease WeekSource Reference: Gilger M, et al "Neodymium magnet adult desk toys are associated with an increased rate of magnet ingestions in children and a new risk factor for ingestions in older children and teenagers" DDW 2013; Abstract Mo1207.