[Systematic review of  gastrointestinal injury caused by magnetic foreign body ingestions in children and adolescence].
OBJECTIVE
To study the diagnosis and treatment of gastrointestinal injury caused by magnetic foreign body ingestions in children.


METHODS
A literature search was performed to identify all the studies related to gastrointestinal tract injury caused by ingesting magnetic foreign body using databases including Google, Medline, ISI Web of Knowledge, Ovid, Wanfang data, VIP, CNKI, degree dissertation, meeting abstracts, and request for document delivery. Language was limited to English, Chinese, Japanese, and Korean. Parameters studies were age at diagnosis, gender, country, regional distribution, number of magnetic foreign bodies, source of magnetic foreign bodies, clinical features, diagnosis, and method for foreign body removal.


RESULTS
A total of 98 cases of magnet ingestion were identified from 17 countries and regions. There were 94 patients under the age of 18, with most children younger than 5 years old(62.2%,61/98). The age at peak incidence was 3 years old (16.3%, 16/98). Magnetic foreign bodies ingested included toys(74.5%), medical apparatus(8.2%), accessories(4.1%), and others(6.2%). The number of bodies ranged from 2 to 100. Eleven (11.2%) patients were complicated with allotriophagia or autism. Delay diagnosis and treatment existed in all the patients to varying extents, of whom one died from severe infection. Exploratory laparotomy showed a wide range of bowel damage from the esophagus to the colon, including perforation and intestinal fistula. Intestinal damage was the most common injury (51.0%), followed by intestine-colon fistula (15.3%). All the patients required bowel resection with anastomosis or fistula repair except for 2 children who were managed by endoscopic removal of the foreign bodies.


CONCLUSIONS
Ingesting more than one magnet will lead to severe gastrointestinal injury. Early diagnosis and surgical intervention are important. More precautious measures should be taken for children aged younger than 5 years old.
Department of Hepatobiliary Surgery, Xi'an Jiaotong University, Xi'an, China.
Shi-qi
SQ
Liu
Peng
P
Lei
Yi
Y
Lv
Shan-pei
SP
Wang
Xiao-peng
XP
Yan
Hai-jun
HJ
Ma
Jia
J
Ma
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005547:Foreign Bodies; D041981:Gastrointestinal Tract / Q000293:injuries*; D006801:Humans; D008280:Magnetics