title: Surgical management and morbidity of pediatric magnet ingestions.
abstract: BACKGROUND
  Foreign body ingestion remains a common reason for emergency room visits and operative interventions in the pediatric population. Rare earth magnet ingestion represents a low percentage of all foreign bodies swallowed by children; however, magnets swallowed in multiplicity can result in severe injuries.
  
  
  METHODS
  Pediatric surgeons with membership in the Surgical Section of the American Academy of Pediatrics were surveyed to determine the magnitude and consequences of magnet ingestions in the pediatric population.
  
  
  RESULTS
  About 100 (16%) participant responses reported on 99 magnet ingestions. The median age at ingestion was 3.7 y, and the majority of ingestions (71%) occurred after year 2010. Thirty-two children underwent endoscopy with successful removal in 70% of cases, and multiple magnets were found in 65% of these patients. Seventy-three children required either laparotomy (51) or laparoscopy (22) for magnet removal, and 90% of these children were discovered to have ingested more than one magnet. In addition, 17% of the children were found to have at least one perforation or fistula, and 34% of the children had multiple perforations or fistulae. Nine children required long-term care for their injuries including repeat endoscopies. One child died after hemorrhage from an esophago-aortic fistula.
  
  
  CONCLUSIONS
  These results demonstrated the increasing need for magnet regulations and public awareness to prevent potentially serious complications.
authors.affiliation: Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Alicia M
authors.initials: AM
authors.lastname: Waters
authors.affiliation: Department of Surgery, University of Michigan, Ann Arbor, Michigan.
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Teitelbaum
authors.affiliation: Surgical Section, American Academy of Pediatrics, Elk Grove Village, Illinois.
authors.forename: Vivian
authors.initials: V
authors.lastname: Thorne
authors.affiliation: Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts.
authors.forename: Athos
authors.initials: A
authors.lastname: Bousvaros
authors.affiliation: Department of Otolayrngology, Baylor College of Medicine, Children's Hospital of San Antonio, San Antonio, Texas.
authors.forename: R Adam
authors.initials: RA
authors.lastname: Noel
authors.affiliation: Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama. Electronic address: elizabeth.beierle@childrensal.org.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Beierle
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004435:Eating; D016099:Endoscopy, Gastrointestinal / Q000706:statistics & numerical data*; D005260:Female; D005547:Foreign Bodies / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000706:statistics & numerical data*; D007813:Laparotomy / Q000706:statistics & numerical data*; D059346:Magnets; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
keywords: Earth magnet; Endoscopy; Magnet ingestion; Pediatric