When we eat, it is supposed to be food or fluids to keep us healthy. But sometimes children will eat foreign bodies out of curiosity, and adults might do the same by accident. When this happens, the patient comes to the emergency department, where X-rays have shown us a long list of ingestibles that were not meant to be consumed. Spoons, bottle caps, paper clips, and coins are often seen in children. Adults may accidentally swallow odd bits as well. I've seen this with a home "handy" man who kept his spare nails and tacks in his mouth while repairing a sofa, until he surprised himself with a cough. They next showed up on his stomach X-ray. Happily, most of these items are harmless and will eventually pass through in the stools.
However, there is a new threat from the world of jewelry. High-powered neodymium magnets are being used as clasps for necklaces or bracelets and as the backing for fake body piercings including earlobes, noses, and lips. These are popular with all ages, from adults to adolescents and even for dress-up fake jewelry for children. Some are being used as refrigerator magnets to hold artwork in place. If any of these small, powerful magnets gets accidentally swallowed (including by children who find the magnets on a counter), the threat level is a lot more serious than the same-sized object that is magnetically inert.
The reason is that magnets inside the gut can strongly attract themselves to another magnet or piece of metal in an adjacent loop of bowel, forcing the walls of the bowels to be crushed between them. With these strong magnets, this can cut off the blood supply to the bowel wall, which can destroy the underlying tissues. This can lead to a perforation, with leakage of the bowel contents into the abdominal cavity. Often a fever spikes, and the abdomen is painful. If not diagnosed swiftly, this can be very dangerous, even fatal.
A recent study done in the Louisiana State University, New Orleans, showed that an alarming 80 percent of children who swallowed magnets had to have medical or surgical intervention. Some needed endoscopy to remove the magnets, others needed additional surgery to repair a hole in the bowel, or, if damage was severe, to do a bowel resection. Half the cases were children under the age of 6, and adolescents were involved in almost a quarter of the cases. In other hospitals hundreds of cases are being seen from adults who may have innocently held a couple of magnets in their mouth (while adjusting ear rings, for example), or removed the outer part of a fake lip or cheek piercing, then accidentally swallowed the magnet that was on the inside of the mouth.
The action item here is to treat all magnets with extra caution:
1. Don't ever put magnets in your mouth, even for a few moments.
2. Never leave small magnets anywhere that your kids could reach.
3. If you suspect a magnet has been swallowed, please see your doctor promptly.
For more info, see the Canadian Medical Post report on the Digestive Disease Week presentation in Orlando, June 25, 2013. The lead doctor of the above study was Associate Professor R. Adam Noel, from the pediatrics department of the Louisiana State University in New Orleans.
If you would like to see more examples of ingested foreign bodies: http://lifeinthefastlane.com/2009/10/top-ten-foreign-bodies/
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