Clinical experience summary of gastroinstinal injury caused by magnets ingestion in children / 国际外科学杂志

ABSTRACT

Objective:To explore the clinical characteristic, pathogenesis, diagnosis and treatment strategies of gastroinstinal injury caused by magnets ingestion in children.Methods:A retrospective analysis of 46 patients with gastrointestinal tract magnets ingestion in Anhui Provincial Children′s Hospital from October 2017 to September 2021 was performed. Patients were divided into different groups according to gastroinstinal perforation. Some basic information was collected, including gender, age, duration of swallow foreign bodies, quantity of foreign bodies, symptoms, white blood cell, neutrophil, C-reactive protein, therapeutic method, gastroinstinal injury and follow up. Logistic regression. Univariate analysis and multivariate Logistic regression were used to analysis the risk factors of gastroinstinal perforation. Continuous parametric data were summarized using median and interquartile range, differences were evaluated using Wilcoxon Mann-Whitney test.Noncontinuous data were analyzed using chi-square test or corrected chi-square test.Results:Among the 46 patients, there were 33 males and 13 females. The median age was 3 years, with a range of 8 months to 11years. 34 cases had a history of ingesting magnets. The common number of ingested magnets was 2-10 (25 cases). Vomiting (18 cases) and abdominal pain (13 cases)were the commonest complaint. 6 cases tend to pass through the gastrointestinal tract uneventfully, and the remaining cases were successfully extracted by endoscopy (5 cases) and surgery(35 cases). Gastroinstinal perforation was found in 28 cases, and the majority of perforation was located in the ileum (18 cases). Univariate analysis showed that symptom, white blood cell, neutrophil, and CRP were associated with gastroinstinal perforation ( P<0.05). Multivariate Logistic regression analysis showed that symptom( OR=4.715, 95% CI: 1.074-20.696, P=0.040) and CRP( OR=11.605, 95% CI: 1.132-118.981, P=0.039) were independent factors for gastroinstinal perforation. There was no significant correlation between the number of magnets and gastroinstinal perforation ( r=0.276, P>0.05). Conclusions:The ingestion of magnetic foreign bodies in children often requires urgent management.When magnets are located within the prepyloric part of the GI tract, retrieval by endoscopy is recommended.The surgical intervention is required as soon as possible due to the failure of endoscopic treatment.