COMMENTARY

Neodymium Magnets: Too Attractive?

William F. Balistreri, MD

Disclosures

March 12, 2014

In This Article

Neodymium Supermagnetic Ingestion

The ingestion of neodymium supermagnets by young children is an underappreciated danger. These magnets are innocent-appearing, yet they are powerful.

During the past year, this was a recurring story for pediatricians, and especially for emergency department (ED) physicians and gastroenterologists; however, most primary care providers may not be aware of the danger presented by these popular "adult toys."

Your Child Ate What?

For a pediatric gastroenterologist, ingested foreign bodies are the subject of many middle-of-the-night calls. When we hear that a child "swallowed something," we must attempt to ascertain the location of the item (esophagus, stomach, or beyond) and its nature (round, sharp, harmless, caustic), and then decide whether and when to intervene.

Typically, 80%-90% of ingested foreign bodies (eg, coins) pass spontaneously; however, 10%-20% will require endoscopic removal, and approximately 1% require surgical intervention.[1,2,3] The assessment of benefit vs risk includes a best guess as to whether the object poses the risk for a serious complication that would warrant urgent removal.

With supermagnets, the rules have changed.

Magnetic Attraction

In the past 10 years, an increasing number of cases concerning injury related to magnet ingestions have been reported. Recent reports indicate that the incidence of ED visits for children with possible magnet ingestion increased 8.5-fold, with a 75% average annual increase.[1,2,3,4,5,6,7,8,9,10,11]

Most patients reported to have ingested magnets were younger than 5 years, as expected. However, in the past few years, there has been an increase in older children ingesting multiple small, round supermagnets. This changing patient demographic has been attributed to an increase in the use of these magnets as "body jewelry" and "fake piercings" by teenagers.[12,13,14] Gastrointestinal endoscopy was performed for magnet removal in 10%-12% of these children, and 4%-5% required surgical intervention. Of ingestion injuries requiring admission or procedural intervention, many were ingestions of "supermagnets."

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