Magnetic beads - Hazardous beauty

04/26/2020 00:00:00 https://www.pediatriconcall.com/Journal/images/journal_cover.jpg

Magnetic beads - Hazardous beauty

Mas Ayu B, Sakina G.
Department of Otorhinolaryngology, University Malaya Medical Centre, Malaysia.

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 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 anteroposterior neck radiograph was performed (Fig 1A, 1B) prior to examination of the patient which showed 3 magnetic beads at the level of C2. Intraoral examination showed one magnetic bead of size 0.5 cm seen at the base of the uvula anteriorly and sandwiched with another 2 beads at the left superior pole of the tonsil posteriorly. Bedside flexible nasendoscopy findings revealed magnetic beads at the soft palate region. Foreign body was removed at the 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 the oral cavity is mostly simple and can be performed in a clinic setting. In this case, we use Tilley’s forceps (metal) to grab one of the beads that was located at the base of the uvula. Using metal instruments 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 a foreign body can dislodge in the airway causing partial or complete airway obstruction especially due to the small airway calibre in children. Dislodged magnetic beads can cause a wide range of bowel damage, including perforation, intestinal fistula and asymptomatic obstruction leading to bowel ischemia.1 Consequently, delayed presentation and diagnosis will probably result in more extensive bowel resection.1 Essentially, a 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 the pediatric age group.
 
Compliance with Ethical Standards
Funding None
 
Conflict of Interest None
 
  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: 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: 92-93. doi: 10.7199/ped.oncall.2020.36
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