Pediatric emergency medicine trisk 0680 0680
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sporadic cases of systemic absorption of battery contents have been suggested in
the literature, and no serious toxicities have been reported.
Magnet Ingestions
Though most magnets that are ingested tend to be small and blunt, they pose a
unique hazard to children. Single magnet ingestions can be treated similarly to
coin ingestions, with outpatient follow-up and monitoring. Multiple magnet
ingestions, however, can be potentially dangerous. If the magnets connect in the
stomach and travel as a single foreign body, there is generally little need for
concern. If they traverse the GI tract separately, they may magnetically attract
each other across the bowel wall, trapping bowel in between the magnets.
Continued magnetic adherence can result in bowel obstruction, pressure necrosis,
and bowel perforation. Removal of a single magnet should be considered if the
patient is at risk for further ingestions. Parents should be advised to remove small
metallic and magnetic objects from the child’s environment. All ingestions
involving multiple magnets require surgical and/or gastroenterology consultation.
Multiple magnets located in the esophagus or stomach should be removed by
endoscopy. For the asymptomatic patient with multiple magnets located beyond
the stomach, serial radiographs and abdominal examinations can be performed to
monitor progression. If the patient is symptomatic and the magnets are beyond
the stomach, surgical intervention is indicated.
FIGURE 32.5 Two-view chest radiograph demonstrating a button battery in the esophagus.
Note the “double rim” or “halo” effect on the AP radiograph (A ) and step-off pattern on the
lateral view (B ).
Respiratory Foreign Body
