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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.
Unfortunately, reports of magnet ingestion injury have failed to describe the physical properties of the offending magnets (ie, surface fields and attraction force). This limits the insight that can be gleaned regarding the underlying biology of compression injury. Through physical modeling and experimental animal work, we have demonstrated that the critical components that determine outcomes are the topology of the compressing surfaces and the magnitude of the magnetic fields. In fact, remodeling by compression can be harnessed to safely form intentional anastomoses, a process that we have demonstrated in pigs. The medical community could learn more from these unfortunate experiments of ingestion with more information about the specific properties of the offending magnets. We solicit physicians caring for such patients to submit the retrieved magnets to our laboratory for physical characterization and testing (for which we have institutional review board approval). Correlation with the associated clinical history, photographs, and tissue would further facilitate evaluation.
Correspondence: Dr Jamshidi, Department of Surgery, University of California–San Francisco, 513 Parnassus Ave, Health Sciences West 1601, San Francisco, CA 94143-0570 (ramin.jamshidi@ucsf.edu).
Author Contributions:Study concept and design: Jamshidi and Harrison. Acquisition of data: Jamshidi. Analysis and interpretation of data: Jamshidi. Drafting of the manuscript: Jamshidi. Critical revision of the manuscript for important intellectual content: Jamshidi and Harrison. Obtained funding: Harrison. Study supervision: Harrison.
Financial Disclosure: None reported.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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