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
ARTICLE HIGHLIGHTS
Research background
In recent years, the incidence of magnetic foreign body ingestion has increased rapidly in our hospital. Almost all of the ingested magnetic foreign bodies were magnetic beads. Most of the patients had intestinal perforations and suffered substantial damage.
Research motivation
Obvious differences exist in clinical symptoms between magnetic and non-magnetic foreign body ingestion. We aimed to summarize clinical experiences and optimize the diagnosis and treatment in dealing with this condition.
Research objectives
To summarize the valuable surgical experiences of multiple-magnet ingestion in children, such as no leakage of the intestinal contents in the abdominal cavity, ileus related symptoms and so on.
Research methods
The experiences of surgeries within the recent 10 years were collected, and the clinical characteristics, treatment, and prognosis were summarized and analyzed. Several typical cases were selected and discussed.
Research results
Through the observational study of 56 cases, we are sure that the most effective way to reduce the increasingly high incidence of injury from magnetic foreign body ingestion is to ban the sale of powerful magnetic toys like buckyballs for minors, and keep children stay far away from the powerful magnetic toys in their living environments. Furthermore, magnetic beads causing intestinal perforation without intestinal content leakage is a discovery that can be used clinically. How to make an appropriate diagnosis and treatment plan to reduce the injury on children is an urgent problem to be solved.
Research conclusions
The key way to reduce the incidence of magnetic foreign body ingestion is to ban the sale of magnetic toys. Clinicians can try new operation methods and determine the indications of this emergency according to the characteristic that intestinal contents will not leak into the abdominal cavity because the intestines stick together tightly. Meanwhile, additional observation is required to monitor long-term complications.
Research perspectives
The direction of the future research is to reduce the incidence of multiple magnet ingestion, relieve the injury to patients, and apply minimally invasive technique in this emergency.
