Multicenter study of pediatric alimentary tract magnetic foreign body ingestion in China

Abstract Abstract Background: To investigate the alimentary tract Buckyball injuries in Chinese pediatric patients, and describe the managements and precautionary measures through multicenter investigation. Methods: Medical records of 74 pediatric patients from 9 large Chinese third-grade class-A hospitals were included in this study. Questionnaires were distributed online, and medical records were reviewed. Follow-ups were 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 numbers showed sharp increase, and Hebei Province had the largest number of 23 cases. Only 3 of them had exact reasons for swallowing the balls, the rest 71 patients had no intension for the ingestion. From onset to the emergency department time was 2.00 (1.00, 5.25) days, varied from 4 hours to 40 days. Twenty-one patients had no symptoms, and abdominal pain, vomiting, fever, abdominal distension, fiercely crying, melena, and flatus and defecation stopped were in 40 (54.05%), 36 (48.65%), 11 (14.86%), 3 (4.05%), 3 (4.05%), 2 (2.70%), 1 (1.35%) cases. Gastroscope, coloscope, laparoscopic operation, and laparotomy operation were adopted. Gastrointestinal perforation, ischemia and necrosis of gastrointestinal wall, abscess, ileus, fistula was found in 38 (51.53%), 14 (18.92%), 7 (9.46%), 6 (8.11%), 2 (2.70%), other 28 (37.84%) patients had gastrointestinal mucosa erosion. 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 time swallowing of Buckyballs or other magnetic foreign bodies. Conclusions: Pediatric alimentary tract magnetic foreign body ingestion in China is still increasing. Treatments and managements are of great significance, while prevention is more important and time critical. Precautionary measures toward the issue should be taken from three levels. Keywords: Pediatric, Alimentary tract, Magnetic foreign body, Buckball