Ingestion of multiple magnets in children.

BACKGROUND: The ingestion of multiple magnets is harmful in children because it can cause intestinal obstruction and/or perforation. We present an approach for the management of children visiting the emergency department with multiple magnet ingestion. METHODS: We retrospectively investigated 9 children who presented to 2 centers in Korea between January 2004 and August 2018 with a history of multiple magnet ingestion. Demographics, major symptoms, management, and outcomes were analyzed. RESULTS: Of the 9 children investigated, median age was 34 months with vomiting and abdominal pain as the most common initial symptoms. Six (67%) underwent surgical removal of the magnets after observing for mean 2.2 days. Reasons for surgical managements were no magnet migration on serial radiographs in 3, suspected obstruction or microperforation in 2 and failed endoscopic removal in 1. Three patients (33%) were asymptomatic and were treated with meticulous observation using serial plain radiographs for average 3.3 days. All patients discharged without adverse outcomes and complications. CONCLUSIONS: Surgical removal is warranted in patients with symptoms suspicious of intestinal obstruction and/or perforation or without magnet migration. Asymptomatic children can be observed over at least 2-3 days with serial simple radiographs while awaiting magnet migration. LEVEL OF EVIDENCE: IV.