"Mommy, I swallowed some magnets." The Dangers of Foreign Bodies and Children.
"Mommy, I swallowed some magnets."
When 4-year-old Coralie admitted what she'd done, her mom, Alysha Varley, didn't hesitate to go straight to the internet. After all, it wasn't long ago that Coralie told her mom she'd stuck popcorn up her nose, and sure enough, there was a kernel wedged in one of her nostrils.
Varley said she's still not sure where her little girl found the magnets. Perhaps it was from the neighbor's house where Coralie stays while Varley works. Regardless, Coralie swallowed the magnets playing downstairs, while Varley was upstairs with her son. Coralie walked upstairs to calmly deliver the news that she’d swallowed the magnets to her mom.
Still, Varley is a nurse. She’s not one to panic or rush her child to the emergency room, unless she believes it’s absolutely necessary.
After reading about the dangers of magnets and calling an on-call nurse, Varley scooped up her daughter and drove to Cook Children's Emergency Department. They arrived at Cook Children's around 10:30 p.m.
The gastroenterology team has treated 27 children for ingestions of foreign bodies so far this year, averaging about five a month. Coralie was the second child treated for swallowing magnets. Dr. Anani estimates his team will remove 60 to 80 foreign bodies a year, with about six to eight of those episodes being magnets.
In a study performed by the U.S. Consumer Product Safety Commission, high powered magnet sets accounted for 1,700 emergency room-treated injuries between 2009 and 2011. The majority of injuries (70 %) were to children 4 to 12 years of age.
Many of these magnet sets are marketed as sculptures, puzzles, and stress relievers and are labeled not for use by children. However, CPSC staff believes these magnet sets have a strong appeal to children and pose a potential for high-severity injuries.
"Magnets can be hazardous," Dr. Anani said. "They can get stuck in the esophagus and cause problems with swallowing (larger fridge magnets). If swallowed, these magnets, especially the smaller, ball-sized ones, can link together inside a child's intestines. They clamp onto body tissues, causing intestinal obstructions, perforations, sepsis, and even death. Internal damage from magnets can pose serious lifelong health effects."
Gastroenterologists and emergency personnel recognize these ingestions for the cause of increased morbidity and mortality among children. The frequent use of neodymium, or rare-earth, magnets in toys and other small objects are especially dangerous. These magnets have more than five times the attractive force of conventional magnets. They have demonstrated the tendency to cause GI injury much more readily than their traditional counterparts. Although the same potential for damage and principles for management applies to non-neodymium magnets, the relative risk is significantly less because of their decreased magnetic pull.
The magnetic balls, Coralie swallowed are used as toys and known as “buckyballs.” The North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) has called for the ban of high-powered magnets as toys.
Dr. Anani was able to retrieve the magnets using an endoscope and a forceps with a metal tip, the magnets attached to the tip and were safely removed from Coralie’s stomach.
Typically the procedure lasts from 30 minutes to a little more than an hour. The length depends on the magnets' location, the number swallowed, and if they are all attached or scattered throughout the GI tract.
Coralie was able to have the procedure, recover from the anesthesia, and be released from the hospital in time to be back at her home in Keller by 4:30 that morning.
Like Coralie, most children seen for ingestion injuries are between the ages of 4-12 years of age. In infants below 2, the magnets tend to remain in the stomach and are easier to retrieve. Older teens usually report the ingestions sooner which allows for quicker intervention and reduces the risk of complications
After the magnets are retrieved safely, the child returns to regular activities once the anesthesia wears off. In some cases, if it has passed into the part of the duodenum (the part of the small intestine immediately beyond the stomach), the child can be admitted and watched closely. Most patients expel the magnets without incident but are usually observed in the hospital until it happens. In some cases, the child may need surgery to avoid gastrointestinal complications.
Dr. Anani asks that parents do their best to avoid buying these high powered magnets as toys if possible. He also warns of the dangers of lithium button batteries (20 mm size) that, if stuck in the esophagus, are a real life-threatening medical emergency.
As for Coralie, she's at home two weeks after swallowing the magnets and doing great.
My first child was not like this one," Varley says with a laugh. "Coralie has a big personality. That's for sure. We talked after she put popcorn up her nose about not putting anything in any other place. So I guess we will have another talk about magnets."
Hopefully, we will all listen to the warning.
Get to know Anthony Anani, M.D., MBA, MPH, FAAP
"The gastrointestinal (GI) tract is an essential part of what makes us human. Our ability to share a meal with family and friends, to grow to our full potential and to excrete waste products from the body, is very dependent on a healthy GI tract. But when something isn't working correctly, it can cause a lot of health and growth problems.
I've always had an interest in how the GI tract works, and especially how it impacts children. It's a privilege to care for kids with these issues and help them achieve their God given potential.
I joined Cook Children's in 2019, and really enjoy the ability to collaborate with other clinicians and care providers to help the children we care for get well and stay out of the hospital. Caring for children is such a rewarding experience and I'm grateful I get the opportunity to do that every day at work.
When I'm not spending time with kids and families at Cook Children's, I can be found spending time with my own kids and family. I also enjoy sports, especially basketball, and look forward to hearing all about the sporting and academic achievements of my patients."