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Magnetic beads - Hazardous beauty

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Magnetic beads - Hazardous beauty

Mas Ayu B, Sakina G.
Department of Otorhinolaryngology, University Malaya Medical Centre, Malaysia.
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B M A, G S. Magnetic beads - Hazardous beauty. Pediatr Oncall J. 2020;17. doi: 10.7199/ped.oncall.2020.36

ARTICLE HISTORY
Received 26 April 2020
Accepted 20 June 2020

ADDRESS FOR CORRESPONDANCE
Dr Sakina Ghauth. Department of Otorhinolaryngology, University of Malaya Medical Centre, Lembah Pantai 59100 Kuala Lumpur, Malaysia.
Email: sakina.ghauth@gmail.com

Keywords
foreign body, magnetic beads
 
A 26 months old boy was referred from the emergency department with a sudden onset dysphagia and excessive drooling of saliva while playing with magnetic beads. He was playing with his older sibling without adult supervision. On examination, he appeared uncomfortable with drooling of saliva. There was no stridor, cyanosis or palpable neck mass. A lateral and antero-posterior neck radiograph was performed (Fig 1A, 1B) prior to examination of patient which showed 3 magnetic beads at the level of C2. Intraoral examination showed one magnetic bead of size 0.5cm seen at the base of uvula anteriorly and sandwiched with another 2 beads at left superior pole of tonsil posteriorly. Bedside flexible nasoendoscopy findings revealed magnetic beads at the soft palate region. Foreign body was removed at bedside using Tilley’s forceps (Fig 2). The procedure was uneventful.

Figure 1 (A). Lateral neck radiograph showing 3 round opacities foreign body at level of C2. (1B) AP neck radiograph with 3 round opacities foreign body in the oropharynx


Figure 2. Magnetic beads post removal from oral cavity


Ingestion of magnetic beads in children has been increasingly reported lately due to its attractiveness. Most cases presented with ingestion in the gastrointestinal system1,2 and rarely stuck in the oral cavity. Management of foreign body in oral cavity is mostly simple and can be performed in clinic setting. In this case, we use a Tilley’s forceps (metal) to grab one of the beads that was located at the base of uvula. Using metal instrument or magnets for removal of magnetic beads in the oral cavity is helpful as the magnetic force will attract the other beads for complete removal. However, precautions need to be taken as foreign body can dislodge in the airway causing partial or complete airway obstruction especially due to the small airway calibre in children. Dislodged of magnetic beads can possibly cause wide range of bowel damage, including perforation, intestinal fistula and a symptomatic obstruction leading to bowel ischemia.1 Consequently, delayed presentation and diagnosis will probably result in more extensive bowel resection.1 Essentially, high index of suspicion with sudden onset of unexplained symptoms in a healthy child and early intervention of foreign body removal is crucial to reduce morbidity and mortality in paediatric age group.
 
Compliance with Ethical Standards
 
Funding None
 
Conflict of Interest None
 
References:
  1. Lin A, Chan LC, Hon KL, Tsui SY, Pang KK, Cheung HM, Leung AK. Magnetic foreign body ingestion in children: the attractive hazards. Case Rep Pediatr. 2019;2019:3549242.  [CrossRef]  [PubMed]  [PMC free article]
  2. Cho J, Sung K, Lee D. Magnetic foreign body ingestion in pediatric patients: report of three cases. BMC Surg. 2017;17:73.  [CrossRef]  [PubMed]  [PMC free article]

DOI No.: https://doi.org/10.7199/ped.oncall.2020.36

Cite this article as:
B M A, G S. Magnetic beads - Hazardous beauty. Pediatr Oncall J. 2020;17. doi: 10.7199/ped.oncall.2020.36
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