Attracting Danger
Amy Movius, MD
Tuesday, July 24, 2012
Infants and toddlers have been putting objects in their mouths since, well, forever. In fact, it’s part of normal development. Pediatricians are no strangers to scenarios in which items have been accidentally ingested, or swallowed, as a result. Fortunately, if the ingested objects reach the stomach, they usually “just pass through” and no special treatment is needed.
Magnets are a very important and sinister exception to this rule and deserve special discussion.
Magnets are found in more and more toys and household items and, unsurprisingly, ingestions of magnets, mostly by young children, has increased as well. Since the early 2000s, high powered magnets, sometimes called “rare earth magnets” have hit the market. They are found commonly in innocuous appearing desktop toys often comprised of many small shiny and/or colorful spheres that can be arranged into various shapes.
The terrible problem with ingesting these magnets is if two or more magnets are swallowed, they will attract each other and stick together even across layers of tissue. Once attracted together, they will not break apart. As a recent article in the AAP News stated, “Although the tissue of the intestinal tract is tough, it’s no match for these magnets." The tissue that is stuck between these magnets is compressed and damaged or destroyed, leading to bleeding, bowel perforation (holes) and twisting. Even with emergency surgery, large portions of the intestines can be lost, and at least one death has occurred.
In 2009 the Consumer Product and Safety Commission banned sale of these magnets to people less than 14 years old. In response the products were simply relabeled “for adults only” and continued to be sold. Unsurprisingly, the cases of accidental swallowing and its complications continue to increase as well.
Protection against this hazard relies on awareness of the severe and potentially fatal consequences of magnet ingestions and education of others about it as well. It is probably best not to have such items in households with small children. Also, some teenagers have accidentally swallowed these magnets when using them to mimic tongue piercings, so this age group needs education, as well. If you even suspect ingestion, seek IMMEDIATE medical attention. DO NOT ASSUME IT WILL PASS, even if your child looks fine. A simple x-ray can identify if a magnet is present. If a magnet is in the stomach it can be removed with a special scope. If it is in the intestines, x-rays need to be done every few hours to make sure it is moving through the intestines, if not, emergency surgery will be needed. Given the availability and popularity of these items, as well as their seemingly harmless appearance, sharing this information with your family, friends and coworkers is perhaps the best protection there is.
References:
1. Fatal Attraction. Small magnets causing injuries, deaths in children. Gilger and Noel. AAP News, Volume 33, Number 6, June 2012
2. Foreign Bodies of the Esophagus and Gastrointestinal Tract in Children. Gilger et al. UpToDate, June 2012
3. Magnet Ingestion, Schierling et al, Journal of Pediatrics 2007
4. Toy Magnet Ingestion In Children: Revising the algorithm. Butterworth and Feltis. Journal of Pediatric Surgery 2007
5. An Intestinal Volvulus caused by multiple magnet ingestion: an unexpected risk in children. Nui et al, Journal of Pediatric Surgery 2005