We read with interest Dutta and Barzin's case report1 regarding complications of multiple magnet ingestion. As the authors concede, similar articles have been published in a variety of medical specialty journals, though almost none comment on or investigate the physical characteristics of the magnets. Reflection on the spectrum of these magnet-ingestion injuries is illuminating. If magnets are swallowed alone, synchronously, or with great separation in time, they are generally innocuous. However, when ingested over some intermediate interval, magnets cause injury because they are in different parts of the gastrointestinal tract when they attract one another. Such transluminal attraction between weaker magnets may create local ulceration or abscesses from slow, contained pressure necrosis. Stronger transluminal attraction can cause severe ischemia and/or lacerating/shearing trauma, which leads to free perforation. Therefore, some children sustain immediate injuries with intestinal perforation, while others develop subacute symptoms culminating in abscesses or fistulae, but the factors that determine which outcome will occur are poorly understood.
Jamshidi R, Harrison M. A Stronger Understanding of Magnet-Ingestion Injuries. Arch Pediatr Adolesc Med. 2008;162(9):900. doi:10.1001/archpedi.162.9.900-a