Multicenter investigation of pediatric alimentary tract magnets ingestion in China

Purpose: To describe the incidence and management of alimentary tract Buckyball ingestion in Chinese pediatric patients, and discuss the precautionary measures through multicenter investigation. Methods: Medical records of 74 pediatric patients from 9 large Chinese hospitals were included in this study. Questionnaires were distributed online, and medical records were reviewed. Follow-up was through telephone and outpatient service. Results: Among the 74 cases were 50 boys (68%) and 24 girls (32%). The age was 36.00 (21.75, 77.00) months, range from 7 months to 11 years old, and it showed two peaks, between one and three years old, and from six to eleven years old. The annual case number showed sharp increase, and the total case number in the last 2 years of 2017 and 2018 showed a 9.25 folds increase than the first 2 years of 2013 and 2014. Only 3 of them had exact reasons for the swallowing, the rest 71 patients had no intension for the ingestion. From onset to the emergency time was 2.00 (1.00, 5.25) days, varied from 4 hours to 40 days. Twenty-one patients had no symptoms, and the rest cases had abdominal pain, vomiting, fever, abdominal distension, fiercely crying, melena, and flatus and defecation stopped. Gastroscope, coloscope, laparoscopic operation, and laparotomy operation were adopted according to the algorithm. Gastrointestinal mucosa erosion, ischemia and necrosis, perforation, and abdominal abscess, ileus, fistula was found in the patients. The numbers of Buckyball ingested was 4 (2, 8), with a range from 1 to 39. During the follow-up period of 6 (1, 15) months, three patients had ileus, and one suffered a second operation. The remaining 71 patients were uneventful. None of the 74 patients reported a second swallowing of foreign bodies. Conclusions: The incidence of pediatric alimentary tract magnets ingestion in China is still increasing. Management of such patients should follow the algorithm. Precautionary measures toward the issue should be taken from three levels. Keywords: Pediatric, Alimentary tract, Magnetic foreign body, Buckball