Swallowing a magnet carries a serious risk, especially due to the modern prevalence of high-powered rare-earth magnets. These small, powerful magnets, often made of neodymium, are significantly stronger than traditional magnets, increasing the potential for internal damage. The danger is particularly acute for children, but adolescents and adults can also be affected, sometimes when using them to mimic body piercings. Prompt recognition and intervention are necessary because the outcome depends heavily on the number of magnets swallowed and the time elapsed before treatment.
The Critical Difference Between One Magnet and Many
A single magnet swallowed alone will often pass through the gastrointestinal (GI) tract without causing injury. However, a single magnet can still become lodged in the esophagus or stomach, which necessitates medical removal.
The severe danger arises when an individual swallows two or more magnets, or a single magnet along with a separate metallic object. These objects can travel independently through the winding loops of the intestines, separated by tissue. The magnetic attraction then pulls the different loops of bowel wall together, trapping the soft tissue between the objects.
This continuous, intense pressure on the intestinal walls cuts off blood flow to the compressed tissue, causing ischemia. The lack of oxygen rapidly leads to tissue death, or pressure necrosis. This process can bore a hole through the intestinal lining, causing perforation, or create an abnormal connection between two parts of the bowel called a fistula. Perforation allows intestinal contents to leak into the abdominal cavity, which can trigger a severe, life-threatening infection called peritonitis.
Recognizing Symptoms and Seeking Emergency Care
If magnet ingestion is known or suspected, immediate emergency medical attention is required, regardless of whether the patient is showing symptoms. Damage caused by multiple magnets can begin quickly, and complications can become severe before symptoms are obvious. Waiting for the object to pass significantly increases the risk of complications, including the need for extensive surgery.
Initial symptoms of internal injury or obstruction are often non-specific and may resemble a common stomach illness. These signs include abdominal pain and repeated vomiting that does not subside. Other signs of potential internal blockage are fever, a distended belly, and a failure to pass stool or gas.
The first action is to go to the emergency department immediately. Do not attempt to induce vomiting, as this risks the object becoming lodged in the throat or being inhaled. Avoid giving the patient laxatives or other medications before consulting a physician, as this can complicate diagnosis and treatment. The medical team needs to assess the situation directly using specialized imaging.
Medical Interventions and Monitoring
Once in the emergency setting, the first step is obtaining immediate imaging, typically X-rays, to determine the exact number, location, and configuration of the ingested magnets. X-rays taken from at least two different angles are necessary, as multiple magnets clustered together can appear as a single object on a single view, masking the true danger. The treatment path depends heavily on these findings.
If a single magnet is confirmed and has passed out of the stomach, conservative management with careful observation may be initiated. This involves monitoring the patient and obtaining serial X-rays every eight to twelve hours to confirm the magnet is progressing through the GI tract. In cases where progression is delayed, a physician may recommend a bowel cleanout protocol using polyethylene glycol (PEG 3350) to encourage passage.
For multiple magnets, or a magnet and another metal object, the standard recommendation is urgent removal. If the magnets are still located in the esophagus, stomach, or upper small intestine, an endoscopy is often the first line of treatment. During this procedure, a flexible tube with a camera is inserted down the throat to visualize and retrieve the objects using specialized tools.
If the magnets have traveled beyond the reach of an endoscope, are stuck in the lower intestine, or if there is evidence of perforation or obstruction, surgical intervention becomes necessary. This often requires a laparotomy or laparoscopy to access the intestines directly, separate the magnets, and repair any damaged or perforated bowel tissue. Delay in treatment significantly increases the likelihood of needing this invasive surgery and the risk of severe complications.