Translational pediatrics · 2026
Clinical characteristics and therapeutic experiences of magnetic foreign body ingestion in children: a single-center retrospective study.
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Yang Binbin, Chen Yi, Zhu Yueling, Chen Weiwei, Jin Yi, Li Wei, Cai Duote, Chen Qingjiang, Gao Zhigang
Аннотация
BACKGROUND: The ingestion of multiple magnetic foreign bodies (MMFBs) poses a growing risk of severe gastrointestinal injury in children, yet optimal management strategies remain debated due to the lack of largescale studies and international consensus. The study aims to summarize the clinical features and treatment experiences associated with the ingestion of MMFB in children.
METHODS: We retrospectively reviewed 160 pediatric patients hospitalized with MMFB ingestion at our institution from June 2016 to August 2025. Clinical data on demographics, symptoms, imaging, treatment modalities, and outcomes were collected. Patients were divided into conservative and surgical groups for comparison, and multivariable logistic regression was used to identify predictors of surgery, perforation, and prolonged hospitalization.
RESULTS: Among the 38.8% (62/160) of patients who received conservative treatment, foreign bodies passed through the anus in 50 cases, were removed by gastroscope in 8 cases, and were extracted by colonoscopy in 1 case. In three patients, the foreign bodies were partially removed by gastroscopy, with the remainder passing spontaneously. Surgical treatment was required in 61.2% (98/160) of patients. In the surgical group, the incidence of gastrointestinal perforation was 92.9% (91/98), and 65.3% (64/98) were symptomatic. Of the 52.0% (51/98) of patients who underwent laparoscopic surgery, 56.8% (29/51) required conversion to laparotomy. A total of 48.0% (47/98) of patients underwent direct laparotomy. The surgical group had a median of seven beads [interquartile range (IQR): 4-12], which was significantly higher than that in the conservative group, which had a median of three beads (IQR: 2-6) (P<0.001). A marked difference in hospital stay length was observed between the surgical and conservative groups [11.5 days (IQR: 10-13 days) vs. 2 days (IQR: 1-3 days); P<0.001]. Furthermore, on multivariable analysis, vomiting [odds ratio (OR) =8.79, P=0.01] and abdominal pain (OR =5.10, P=0.02) were independent predictors of surgical intervention; the number of magnetic beads also independently predicted surgery, with each additional bead increasing the odds by 6% (OR =1.06 per bead, P=0.04). For gastrointestinal perforation, vomiting emerged as the strongest predictor (OR =13.67, P=0.002), followed by abdominal pain (OR =3.88, P=0.04) and number of beads (OR =1.06 per bead, P=0.02). A threshold of four or more magnets conferred substantially increased risk for both outcomes.
CONCLUSIONS: Surgical intervention is required in more than 60% of children with MMFB ingestion, especially when vomiting is present or the magnet count is four or more. Conservative management may be considered in asymptomatic children with fewer magnets, however, timely surgery is critical once symptoms develop.
METHODS: We retrospectively reviewed 160 pediatric patients hospitalized with MMFB ingestion at our institution from June 2016 to August 2025. Clinical data on demographics, symptoms, imaging, treatment modalities, and outcomes were collected. Patients were divided into conservative and surgical groups for comparison, and multivariable logistic regression was used to identify predictors of surgery, perforation, and prolonged hospitalization.
RESULTS: Among the 38.8% (62/160) of patients who received conservative treatment, foreign bodies passed through the anus in 50 cases, were removed by gastroscope in 8 cases, and were extracted by colonoscopy in 1 case. In three patients, the foreign bodies were partially removed by gastroscopy, with the remainder passing spontaneously. Surgical treatment was required in 61.2% (98/160) of patients. In the surgical group, the incidence of gastrointestinal perforation was 92.9% (91/98), and 65.3% (64/98) were symptomatic. Of the 52.0% (51/98) of patients who underwent laparoscopic surgery, 56.8% (29/51) required conversion to laparotomy. A total of 48.0% (47/98) of patients underwent direct laparotomy. The surgical group had a median of seven beads [interquartile range (IQR): 4-12], which was significantly higher than that in the conservative group, which had a median of three beads (IQR: 2-6) (P<0.001). A marked difference in hospital stay length was observed between the surgical and conservative groups [11.5 days (IQR: 10-13 days) vs. 2 days (IQR: 1-3 days); P<0.001]. Furthermore, on multivariable analysis, vomiting [odds ratio (OR) =8.79, P=0.01] and abdominal pain (OR =5.10, P=0.02) were independent predictors of surgical intervention; the number of magnetic beads also independently predicted surgery, with each additional bead increasing the odds by 6% (OR =1.06 per bead, P=0.04). For gastrointestinal perforation, vomiting emerged as the strongest predictor (OR =13.67, P=0.002), followed by abdominal pain (OR =3.88, P=0.04) and number of beads (OR =1.06 per bead, P=0.02). A threshold of four or more magnets conferred substantially increased risk for both outcomes.
CONCLUSIONS: Surgical intervention is required in more than 60% of children with MMFB ingestion, especially when vomiting is present or the magnet count is four or more. Conservative management may be considered in asymptomatic children with fewer magnets, however, timely surgery is critical once symptoms develop.