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Multicenter investigation of pediatric gastrointestinal tract magnets ingestion in China

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机构: [1]Department of General Surgery, Beijing Children’s Hospital, Capital MedicalUniversity, National Center for Children’s Health, No.56 Nanlishi St, XichengDistrict, Beijing 100045, China [2]Department of General Surgery, ZhengzhouChildren’s Hospital, Zhengzhou 450053, Henan, China [3]Department ofGeneral Surgery, Xi’an Children’s Hospital, Xi’an 710043, Shaanxi, China [4]Department of General Surgery, Children’s Hospital of Hebei Province,Shijiazhuang 050030, Hebei, China [5]Department of General Surgery, AnhuiProvincial Children’s Hospital, Hefei 340111, Anhui, China [6]Department ofGeneral Surgery, Jiangxi Provincial Children’s Hospital, Nanchang 330006,Jiangxi, China [7]Department of General Surgery, Children’s Hospital ofNanjing Medical University, Nanjing 210008, China [8]Department of GeneralSurgery, Wuhan Children’s Hospital, Wuhan 430015, Hubei, China [9]Department of Pediatric Surgery, the First Affiliated Hospital of ZhengzhouUniversity, Zhengzhou 450052, Henan, China.
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关键词: Buckyball Gastrointestinal tract Magnetic foreign body Pediatric

摘要:
Purpose: To describe the incidence and management of gastrointestinal tract Buckyball magnets ingestions in a multicenter Chinese pediatric patient population, and discuss the preventive measures. Methods: Medical records of 74 pediatric patients from 9 large Chinese hospitals during the past 10 years, who were diagnosed as buckyball magnets ingestion and got invasive treatment, were retrospectively studied. The follow-up was through telephone and outpatient service to estimate the post-surgery condition. Information collection was through online questionnaire. Results: Among the 74 cases, there were 50 boys (68%) and 24 girls (32%). The median age was 36 (interquartile range (IQR) 22-77) months, with a range of 7 months to 11 years, and it showed two peaks, the first between 1 and 3 years, and the second between 6 to 11 years. The annual case number showed a sharp increase over time, and the total case number in the last 2 years (2017 and 2018) showed a greater than 9-fold increase when compared with the first 2 years (2013 and 2014). The majority of ingestions were unintentional, with only 3 patients deliberately swallowing the Buckyball magnets. The median time of ingestion until the onset of emergent symptoms was 2 (IQR 1-5) days, and ranged from 4 h to 40 days. Twenty-one patients had no symptoms, and the remaining cases presented with abdominal pain, vomiting, fever, abdominal distension, excessive crying, melena, and the ceasing of flatus and defecation. Gastroscopy, colonoscopy, laparoscopic surgery and laparotomy surgery were performed in accordance with the algorithm from the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN). Procedural and operative findings included gastrointestinal mucosa erosion, ischemia and necrosis, perforation, and abdominal abscess, fistula and intestinal obstruction. The median number of Buckyball magnets ingested was 4 (IQR 2-8), with a range from 1 to 39. During the median follow-up period of 6 (IQR 1-15) months, 3 patients had intestinal obstruction, and one underwent a second operation. The remaining 71 patients courses were uneventful during the follow-up period. None of the 74 patients reported a second swallowing of foreign bodies. Conclusions: The incidence of pediatric gastrointestinal tract magnets ingestion in China is increasing. Management of such patients should follow the NASPGHAN algorithm. Preventive measures to limit children's access to Buckyball magnets should be taken from three levels, namely the national administration, producer, and consumer. © 2020 The Author(s).

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出版当年[2019]版:
大类 | 4 区 医学
小类 | 3 区 儿科
最新[2023]版:
大类 | 3 区 医学
小类 | 3 区 儿科
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Q2 PEDIATRICS
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Q2 PEDIATRICS

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第一作者机构: [1]Department of General Surgery, Beijing Children’s Hospital, Capital MedicalUniversity, National Center for Children’s Health, No.56 Nanlishi St, XichengDistrict, Beijing 100045, China
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通讯机构: [1]Department of General Surgery, Beijing Children’s Hospital, Capital MedicalUniversity, National Center for Children’s Health, No.56 Nanlishi St, XichengDistrict, Beijing 100045, China
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