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OBJECTIVES: To describe operative techniques using rigid bronchoscopy and ferromagnetic bronchoscopic equipment to retrieve magnetic foreign bodies in distal tertiary bronchi beyond the reach of traditional optical instrumentation. METHODS: A 13-year-old presented to the Emergency Department following aspiration of three backing magnets from a magnetic nose ring. Chest radiographs demonstrated a 4 mm × 3 mm foreign body in the right lower lobe 0.5 cm from diaphragm on expiratory film. She was taken to the operating room for removal of an airway foreign body. RESULTS: The foreign body was visualized with direct laryngoscopy followed by rigid bronchoscopy in the distal right lower tertiary bronchus. Attempts to pass optical instruments were limited both by distance of the object and size of instrumentation compared to the diameter of the tertiary bronchus. A salivary wire basket and ureteral stone retrieval basket were then passed with endoscopic visualization into the tertiary bronchus but were unable to engage the foreign body. An attempt was made to pass a 2 French Fogarty embolectomy catheter distally, but the catheter was too large to bypass the foreign body. Finally, ferromagnetic pulmonary rat tooth biopsy forceps were advanced into the tertiary bronchus and successfully attracted the magnetic foreign body for safe removal through our rigid bronchoscope. CONCLUSION: We present a novel method of utilizing ferromagnetic flexible bronchoscopic instruments to safely remove magnetic foreign bodies in the tertiary bronchi beyond the reach of traditional bronchoscopic instruments. Laryngoscope, 2024.

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Magnetic foreign body ingestion poses a threat especially if more than one is ingested. If consumed alone, small magnetic foreign bodies are likely to pass without significant event; however, when multiple magnets are ingested, they can be attracted to each other through the intestinal wall, which may lead to serious consequences and complications, including bowel perforation, obstruction, peritonitis, and death. We report a case of a 2-years male child patient presented with multiple small round magnetic beads ingestion from a magnetic pendant that appeared like a necklace pearl after conglomeration on abdominal radiograph. On exploration, we found multiple perforations involving ileum, cecum, and transverse colon, with multiple conglomerated beads extruding from the perforation sites.

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BACKGROUND/AIMS: To investigate the clinical situation, treatment methods, and clinical predictors of surgical intervention in children with magnetic foreign bodies in the digestive tract. MATERIALS AND METHODS: From January 2019 to June 2022, we retrospectively analyzed the clinical data of 72 children who ingested magnetic foreign bodies inadvertently in our hospital, including their general information, admissions, clinical manifestations, and treatment methods, as well as pertinent literature and statistical data. Following software processing, univariate and multivariate logistic regression analyses were conducted to determine the independent risk factors of this study. RESULTS: In this study, 16 patients (22.2%) were discharged smoothly following conservative treatment and 19 patients (26.4%) were cured by gastroscopy. The remaining 37 patients (51.4%) were underwent surgery, in which 26 cases developed gastrointestinal perforation. There were statistical differences between surgery group and non- surgery group in the days of eating by mistake, clinical manifestations (nausea and vomiting, intermittent abdominal pain, abdominal muscle tension) and movement trajectory by every 24-h radiograph (P < 0.01). Logistic regression analysis showed that intermittent abdominal pain and abdominal muscle tension were independent risk factors for surgical treatment. CONCLUSION: Magnetic foreign bodies seriously endanger children's health. This study offers a single-center basis for the choice of surgical opportunity for intestinal obstruction or perforation caused by magnetic foreign bodies. Clinicians need immediate surgical intervention if the child shows symptoms of abdominal pain or abdominal tension.

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Cuerpos Extraños , Tracto Gastrointestinal , Niño , Humanos , Estudios Retrospectivos , Dolor Abdominal/etiología , Cuerpos Extraños/diagnóstico por imagen , Cuerpos Extraños/cirugía , Fenómenos Magnéticos

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Objective:To explore the clinical application of magnetic foreign body extractor in metal foreign body of upper digestive tract children.Methods:The clinical data of 115 children with metallic foreign bodies in the upper digestive tract who were admitted to the Department of Pediatrics, the Second Affiliated Hospital of Air Force Medical University, from January 2017 to September 2022, were selected as subjects.All the metallic foreign bodies were removed by a self-made metallic foreign body extractor in the department.The clinical characteristics of the metallic foreign bodies in the upper digestive tract were comprehensively analyzed by using descriptive analysis methods, summarize the age, gender, metallic foreign body type, number of the metallic foreign bodies, incarcerated location, retention time, clinical symptoms and complications.Results:A total of 115 children with metallic foreign bodies in the upper digestive tract were included in the analysis, involving 51 males and 64 females, with a mean age of (3.63±2.28) years.The majority was children aged 0-3 years (68/115, 59.1%). Coins (86 cases, 74.8%) were the major foreign bodies in metal foreign body of upper digestive tract, followed by button batteries (11 cases, 9.6%), magnetic balls (8 cases, 7.0%), and others (10 cases, 8.6%). The main clinical symptoms were nausea, vomiting, abdominal pain, chest pain, and foreign body sensation, and button battery ingestion and magnetic balls were easy to produce complications.The primary retention sites of metallic foreign bodies were the gastric fundus (75 cases, 65.2%), followed by upper esophageal segment (38 cases, 33.0%) and lower esophageal segment(2 cases, 1.7%).Conclusions:In children′s metal foreign body of upper digestive tract, coins are the most common foreign bodies that are easily retained in the stomach fundus.Button batteries are prone to cause severe complications and should be removed timely.The self-made metallic foreign body extractor in our department can remove coins, batteries, magnetic balls, nails, chains, party emblems and other metallic foreign bodies.It can shorten the operation time, improve the removal efficiency, and featured by active search, strong adsorption, no mucosal damage and removal with the endoscope, which can be widely used in the clinical treatment of metallic foreign bodies.

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BACKGROUND: Multiple magnetic foreign body ingestion in children is increasingly common and can cause serious injury. The present study aimed to analyze the clinical features of such cases and summarize treatment experiences. METHODS: A retrospective survey of 91 patients in the Children's Hospital, Zhejiang University School of Medicine with magnetic foreign body ingestion from October 2018 to October 2021 was performed, the data were collected including the clinical information of the patients, treatment details, and prognosis. RESULTS: Twenty-two (24.2%) patients were conservatively treated, with the foreign bodies discharged through the anus, 31 (34.1%) underwent laparoscopic surgery, including 18 cases converting from laparoscopic surgery to laparotomy, and 38 (41.8%) underwent laparotomy. In 13 (14.3%) patients, the foreign bodies were partially removed by gastroscope. The remaining foreign bodies were removed by laparoscopy in six patients, including three cases converting from laparoscopy to laparotomy, by laparotomy in four patients, and by conservative treatment in three patients. CONCLUSIONS: Multiple magnetic foreign body ingestion can cause significant harm to patients and different clinical techniques must be used for patients in different situations to reduce the harm to children.

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Cuerpos Extraños , Niño , Ingestión de Alimentos , Cuerpos Extraños/diagnóstico por imagen , Cuerpos Extraños/cirugía , Humanos , Laparotomía/métodos , Fenómenos Magnéticos , Estudios Retrospectivos

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Objective:To explore the clinical characteristic, pathogenesis, diagnosis and treatment strategies of gastroinstinal injury caused by magnets ingestion in children.Methods:A retrospective analysis of 46 patients with gastrointestinal tract magnets ingestion in Anhui Provincial Children′s Hospital from October 2017 to September 2021 was performed. Patients were divided into different groups according to gastroinstinal perforation. Some basic information was collected, including gender, age, duration of swallow foreign bodies, quantity of foreign bodies, symptoms, white blood cell, neutrophil, C-reactive protein, therapeutic method, gastroinstinal injury and follow up. Logistic regression. Univariate analysis and multivariate Logistic regression were used to analysis the risk factors of gastroinstinal perforation. Continuous parametric data were summarized using median and interquartile range, differences were evaluated using Wilcoxon Mann-Whitney test.Noncontinuous data were analyzed using chi-square test or corrected chi-square test.Results:Among the 46 patients, there were 33 males and 13 females. The median age was 3 years, with a range of 8 months to 11years. 34 cases had a history of ingesting magnets. The common number of ingested magnets was 2-10 (25 cases). Vomiting (18 cases) and abdominal pain (13 cases)were the commonest complaint. 6 cases tend to pass through the gastrointestinal tract uneventfully, and the remaining cases were successfully extracted by endoscopy (5 cases) and surgery(35 cases). Gastroinstinal perforation was found in 28 cases, and the majority of perforation was located in the ileum (18 cases). Univariate analysis showed that symptom, white blood cell, neutrophil, and CRP were associated with gastroinstinal perforation ( P<0.05). Multivariate Logistic regression analysis showed that symptom( OR=4.715, 95% CI: 1.074-20.696, P=0.040) and CRP( OR=11.605, 95% CI: 1.132-118.981, P=0.039) were independent factors for gastroinstinal perforation. There was no significant correlation between the number of magnets and gastroinstinal perforation ( r=0.276, P>0.05). Conclusions:The ingestion of magnetic foreign bodies in children often requires urgent management.When magnets are located within the prepyloric part of the GI tract, retrieval by endoscopy is recommended.The surgical intervention is required as soon as possible due to the failure of endoscopic treatment.

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In recent years, with the increase of magnetic toys, the intake of magnetic foreign bodies is an increasing problem in pediatric emergency.The strong suction of the magnetic foreign body can lead to necrosis, perforation, and infection of surrounding tissues.The site of magnetic foreign body injury is mainly the esophagus, intestines, stomach, a few in the pharynx, etc.This requires early assessment and appropriate intervention to avoid further harm.Because of its unique physical properties, magnetic foreign bodies in bilateral nasal cavity are rarely reported. Now we have a case of a bilateral magnetic foreign body in the nasal cavity.

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Cuerpos Extraños , Cavidad Nasal , Niño , Esófago , Humanos , Fenómenos Magnéticos , Faringe

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Esophageal and tracheal foreign body ingestion trigger common pediatric emergencies. In this case report, we describe a pediatric patient with simultaneous tracheal and esophageal obstruction caused by foreign bodies. A child aged 2 years and 1 month swallowed a pair of metallic magnetic beads at the same time; one bead entered the trachea and the other bead entered the esophagus. We suspected that the two magnetic beads were mutually attracted and thus became trapped in their respective lumina. The tracheal foreign body was uneventfully removed; this dislodged the esophageal foreign body, which was then excreted. There were no serious complications in the present case, but parents and medical personnel should be mindful of the potential hazards associated with ingestion of multiple magnetic foreign bodies. A high index of suspicion is appropriate. Investigations must be carefully planned. Treatment should not be delayed; the consequences of delay may be serious.

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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.

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PURPOSE: To describe the incidence and management of gastrointestinal tract Buckyball magnets ingestions in a multicenter Chinese pediatric patient population, and discuss the preventive measures. METHODS: Medical records of 74 pediatric patients from 9 large Chinese hospitals during the past 10 years, who were diagnosed as buckyball magnets ingestion and got invasive treatment, were retrospectively studied. The follow-up was through telephone and outpatient service to estimate the post-surgery condition. Information collection was through online questionnaire. RESULTS: Among the 74 cases, there were 50 boys (68%) and 24 girls (32%). The median age was 36 (interquartile range (IQR) 22-77) months, with a range of 7 months to 11 years, and it showed two peaks, the first between 1 and 3 years, and the second between 6 to 11 years. The annual case number showed a sharp increase over time, and the total case number in the last 2 years (2017 and 2018) showed a greater than 9-fold increase when compared with the first 2 years (2013 and 2014). The majority of ingestions were unintentional, with only 3 patients deliberately swallowing the Buckyball magnets. The median time of ingestion until the onset of emergent symptoms was 2 (IQR 1-5) days, and ranged from 4 h to 40 days. Twenty-one patients had no symptoms, and the remaining cases presented with abdominal pain, vomiting, fever, abdominal distension, excessive crying, melena, and the ceasing of flatus and defecation. Gastroscopy, colonoscopy, laparoscopic surgery and laparotomy surgery were performed in accordance with the algorithm from the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN). Procedural and operative findings included gastrointestinal mucosa erosion, ischemia and necrosis, perforation, and abdominal abscess, fistula and intestinal obstruction. The median number of Buckyball magnets ingested was 4 (IQR 2-8), with a range from 1 to 39. During the median follow-up period of 6 (IQR 1-15) months, 3 patients had intestinal obstruction, and one underwent a second operation. The remaining 71 patients courses were uneventful during the follow-up period. None of the 74 patients reported a second swallowing of foreign bodies. CONCLUSIONS: The incidence of pediatric gastrointestinal tract magnets ingestion in China is increasing. Management of such patients should follow the NASPGHAN algorithm. Preventive measures to limit children's access to Buckyball magnets should be taken from three levels, namely the national administration, producer, and consumer.

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Cuerpos Extraños , Imanes , Niño , Preescolar , China/epidemiología , Ingestión de Alimentos , Femenino , Cuerpos Extraños/diagnóstico , Cuerpos Extraños/epidemiología , Cuerpos Extraños/cirugía , Tracto Gastrointestinal , Humanos , Lactante , Masculino , Estudios Retrospectivos

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BACKGROUND: Although foreign bodies (FBs) typically pass spontaneously and uneventfully through the digestive tract, a subset of such bodies may become trapped, eventually leading to significant injury. In particular, the ingestion of magnetic materials can cause serious morbidity due to proximate attraction through the intestinal wall. CASE PRESENTATION: We recently treated three pediatric patients who had ingested several magnetic foreign materials. None of these patients exhibited any clinical symptoms or signs suggestive of surgical abdomen. Moreover, it was difficult to determine a definite diagnosis and a treatment plan due to limitations in history taking and radiologic examination. After admission to the hospital, these patients underwent surgery for the following reasons: (1) failure to spontaneously pass ingested foreign materials; (2) sudden-onset abdominal pain and vomiting during hospitalization; and (3) gastric perforation incidentally discovered during gastroduodenoscopy. Subsequently, all patients were discharged without complications; however, their conditions might have been fatal without surgery at an appropriate time. CONCLUSIONS: As the clear identification about the number and characteristics of ingested magnets via radiographic examination or patient history appears to be difficult in pediatric patients, close inpatient observation would be required in any case of undetermined metallic FB ingestion. Patients who are confirmed to have ingested multiple magnets should be regarded as conditional surgical patients, although their clinical conditions are stable.

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Cuerpos Extraños/cirugía , Imanes , Dolor Abdominal/etiología , Preescolar , Femenino , Cuerpos Extraños/complicaciones , Cuerpos Extraños/diagnóstico por imagen , Humanos , Lactante , Masculino , Radiografía Abdominal , Rotura , Estómago/lesiones , Vómitos/etiología

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·AIM:To investigate the surgical method and efficacy of extraction of deep orbital magnetic foreign bodies by mean of an orbital strong magnet.·METHODS: A retrospective analysis of clinical data of patients with deep orbital magnetic foreign bodies ( OMFB ) in Hebei Eye Hospital from June 2014 to May 2017 was processed. A total of 23 eyes were enrolled, among them, 14 eyes of extraorbital OMFB, 9 eyes of intraorbital OMFB. The rate of extraction of foreign bodies and the postoperative complications were observed.·RESULTS: All eyes of intraorbital foreign bodies were successfully extracted with 100% success rate. Twelve of 14 eyes of extraorbital foreign bodies were extracted with 86% success rate. Mild orbital hemorrhage were found in 2 eyes. There was no other obvious complication such as visual loss, orbital massive hemorrhage or limited ocular movement.·CONCLUSION: It's an ideal surgical method to extract the deep orbital magnetic foreign bodies by mean of an orbital strong magnet, with mini-injury, high success rate, short duration and few complications.

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INTRODUCTION: Magnet ingestion usually does not cause serious complications, but in case of multiple magnet ingestion or ingestion of magnet with other metal it could cause intestinal obstruction, fistula formation or even perforation. CASE REPORT: We report case of intestinal obstruction and fistula formation following ingestion of 25 magnets in a 2-year-old girl. Intraoperatively omega shaped intestinal loop with fistula caused by two magnetic balls was found. Intestine trapped with magnetic balls was edematous and inflamed. Resection of intestinal segment was performed, followed by entero-enteric anastomosis. A total of 25 magnets were removed from resected intestine. CONCLUSION: Single magnet ingestion is treated as non-magnetic foreign body. Multiple magnet ingestion should be closely monitored and surgical approach could be the best option to prevent or to cure its complications.

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Cuerpos Extraños/complicaciones , Fístula Intestinal/etiología , Obstrucción Intestinal/etiología , Imanes/efectos adversos , Preescolar , Ingestión de Alimentos , Femenino , Cuerpos Extraños/diagnóstico por imagen , Humanos , Fístula Intestinal/cirugía , Obstrucción Intestinal/cirugía

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Foreign body ingestion is common in infants and young children and they pass spontaneously in most of the cases. Magnetic foreign bodies, though not very common, require early intervention to avoid severe gastrointestinal complications. We report a case of multiple magnet ingestion who presented with peritonitis.