Cai DT, Shu Q, Zhang SH, Liu J, Gao ZG. Surgical treatment of multiple magnet ingestion in children: A single-center study. World J Clin Cases 2020; 8(23): 5988-5998 [PMID: 33344597 DOI: 10.12998/wjcc.v8.i23.5988]
Corresponding Author of This Article
Qiang Shu, PhD, Professor, Department of Pediatric Surgery, the Children’s Hospital of Zhejiang University School of Medicine, No. 3333 Binsheng Road, Hangzhou 310058, Zhejiang Province, China. shuqiang@zju.edu.cn
Research Domain of This Article
Pediatrics
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Duo-Te Cai, Shu-Hao Zhang, Zhi-Gang Gao, Department of General Surgery, the Children’s Hospital of Zhejiang University School of Medicine, Hangzhou 310051, Zhejiang Province, China
Duo-Te Cai, Department of General Surgery, National Clinical Research Center for Child Health, Hangzhou 310051, Zhejiang Province, China
Qiang Shu, Department of Pediatric Surgery, the Children’s Hospital of Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang Province, China
Qiang Shu, Department of Pediatric Surgery, National Clinical Research Center for Child Health, Hangzhou 310058, Zhejiang Province, China
Jia Liu, Department of Ear, Nose, and Throat Surgery, the Children’s Hospital of Zhejiang University School of Medicine, Hangzhou 310051, Zhejiang Province, China
Author contributions: Cai DT designed the study, participated in the acquisition, analysis, and interpretation of the data, and drafted the initial manuscript; Zhang SH and Liu J participated in data acquisition and analysis; Shu Q and Gao ZG revised the article critically for important intellectual content.
Institutional review board statement: The study was reviewed and approved by the Children's Hospital of Zhejiang University Institutional Review Board (Approval No. 2020-IRB-120).
Informed consent statement: Exemption from informed consent application was approved by the Children's Hospital of Zhejiang University Institutional Review Board.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qiang Shu, PhD, Professor, Department of Pediatric Surgery, the Children’s Hospital of Zhejiang University School of Medicine, No. 3333 Binsheng Road, Hangzhou 310058, Zhejiang Province, China. shuqiang@zju.edu.cn
Received: August 30, 2020 Peer-review started: August 30, 2020 First decision: September 13, 2020 Revised: September 15, 2020 Accepted: September 25, 2020 Article in press: September 25, 2020 Published online: December 6, 2020 Processing time: 95 Days and 20.2 Hours
Abstract
BACKGROUND
Since 2017, the number of magnet ingestion cases has increased year over year in our hospital. Almost all of the ingested magnetic foreign bodies were magnetic beads, and most of the patients experienced intestinal perforations, causing substantial damage.
AIM
To summarize our experience with surgical treatment of multiple magnet ingestion in children.
METHODS
The data for general surgeries were collected from January 2010 to April 2020, and the clinical characteristics, treatment methods, and outcomes were summarized and analyzed. Several typical cases were selected and discussed.
RESULTS
Fifty-six cases of ingested magnetic foreign bodies were collected, of which 47 were magnetic beads. The average patient age was 4.7 ± 3.0 years old. The number of ingested magnetic foreign bodies ranged from 2 to 73. There were 26 cases with symptoms at the time of admission, including two cases of shock. Thirteen patients were discharged successfully following conservative treatment and 43 were treated by surgery. Laparotomy was the main method of operation. Laparoscopy was used in four cases, of which three were converted to open surgery, and one was treated successfully using surgery through the navel. Postoperative complications occurred in seven cases, incision infections were observed in six, and adhesive ileus was observed in one.
CONCLUSION
Clinicians need to summarize their experiences with treating magnetic foreign body ingestions in detail and carry out clinical research to reduce the damage to children.
Core Tip: Since 2017, the numbers of magnet ingestion has increased year over year in our hospital and most of the patients experienced intestinal perforations. We found several significant clinical features: Intestinal contents did not leak into the abdominal cavity, and gastrointestinal symptoms were caused by ileus rather than perforation, which were obviously different from intestinal perforation caused by other reasons. This means that the traditional treatment strategy cannot be used simply to deal with intestinal perforation caused by magnetic beads, and a more favorable treatment scheme should be selected according to its clinicopathological characteristics.
