Category: gastroenterology

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gastroenterology

Magnet Ingestions

This episode focuses on high-powered magnet ingestions in children and was a collaboration with Elizabeth Curtis – @egcurtismd and Libby Ireson – @LibbyIreson, two Categorical Pediatrics Residents at Cincinnati Children’s who served as producers and guest hosts. These rare earth magnets were briefly removed from the market because children swallowed them and, when two magnets attracted across opposing loops of bowel, they sustained intestinal injury. Legal machinations led to their reappearance on the market.

This episode is equal parts clinical advice and advocacy in action and will help you discuss these potentially dangerous magnets with families and manage a child in case they swallow one.

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References

CPSC Safety Alert (2007) “Ingested Magnets Can Cause Serious Intestinal Injuries” https://www.cpsc.gov/s3fs-public/5221.pdf   

AAP (2017) “Dangers of Magnetic Toys.” https://www.healthychildren.org/English/safety-prevention/at-home/Pages/Dangers-of-Magnetic-Toys-and-Fake-Piercings.aspx   

Middelberg, L. K., Funk, A. R., Hays, H. L., McKenzie, L. B., Rudolph, B., & Spiller, H. A. (2021). Magnet Injuries in Children: An Analysis of the National Poison Data System From 2008-2019. The Journal of Pediatrics, 0(0). https://doi.org/10.1016/j.jpeds.2021.01.052 

Strickland M, Rosenfield D, Fecteau A. Magnetic foreign body injuries: a large pediatric hospital experience. J Pediatr. 2014 Aug;165(2):332-5. doi: 10.1016/j.jpeds.2014.04.002. Epub 2014 May 16. PMID: 24836391. 

De Roo AC, Thompson MC, Chounthirath T, Xiang H, Cowles NA, Shmuylovskaya L, Smith GA. Rare-earth magnet ingestion-related injuries among children, 2000-2012. Clin Pediatr (Phila). 2013 Nov;52(11):1006-13. doi: 10.1177/0009922813507129. PMID: 24137035. 

Mandhan, P., Alsalihi, M., Mammoo, S., & Ali, M. J. (2014). Troubling toys: rare-earth magnet ingestion in children causing bowel perforations. Case reports in pediatrics, 2014. 

Reeves, P. T., Nylund, C. M., Krishnamurthy, J., Noel, R. A., & Abbas, M. I. (2018). Trends of magnet ingestion in children, an ironic attraction. Journal of pediatric gastroenterology and nutrition, 66(5), e116-e121. 

Spiller, H. (2019) “The Dangers of Magnet Toys.” Nationwide Children’s Hospital www.nationwidechildrens.org/family-resources-education/700childrens/2019/12/magnet-toys

Podcast: Play in new window | Download (Duration: 13:27 — 18.5MB)

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Categories
gastroenterology

Constipation

Constipation is an incredibly common problem in the Pediatric Emergency Department and amongst children who visit the Emergency Department with complaints of abdominal pain. This episode of PEM Currents, the Pediatric Emergency Medicine podcast features an interview with Danny Mallon, a Gastroenterologist from Cincinnati Children’s @dannymallon24 who is an expert in managing pediatric constipation. Our discussion focused on diagnosis in the Emergency Department, management  and why you don’t need an X-Ray to make there diagnosis.

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References

Berger et al. Value of Abdominal Radiography, Colonic Transit Time, and Rectal Ultrasound Scanning in the Diagnosis of Idiopathic Constipation in Children: A Systematic Review. Journal of Pediatrics, 2012.

Hyams et al. Childhood Functional Gastrointestinal Disorders: Child/ Adolescent. Gastroenterology, 2016.

Zeevenhooven et al. The New Rome IV Criteria for Functional Gastrointestinal Disorders in Infants and Toddlers. Pediatr Gastroenterol Hepatol Nutr, 2017.

Podcast: Play in new window | Download (Duration: 17:19 — 24.1MB)

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Categories
gastroenterology Infectious Diseases

Probiotics for Gastroenteritis

This episode of PEM Currents features an in-depth interview with the lead author on the recent New England Journal paper on the use of probiotics in gastroenteritis. David Schnadower was kind enough to sit down with me and James Gray, a Pediatric Emergency Medicine Fellow from Cincinnati Children’s to talk about the study and its implications for the care of children with infectious gastroenteritis. You will find a full transcript of the podcast on PEMBlog.com.

Read the full article from the New England Journal of Medicine.

References

Freedman et al. Multicenter Trial of a Combination Probiotic for Children with Gastroenteritis. N Engl J Med 2018; 379:2015-2026. DOI: 10.1056/NEJMoa1802597.

Schnadower et al. Lactobacillus rhamnosus GG versus Placebo for Acute Gastroenteritis in Children. NEJM 2018; 379:2002-2014. DOI: 10.1056/NEJMoa1802598.

Podcast: Play in new window | Download (Duration: 7:53 — 11.0MB)

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Categories
gastroenterology

Hematemesis in the Newborn

Hematemesis in the newborn period is scary for parents but fortunately it is most often due to benign causes such as swallowed maternal blood or GERD. learn more about this surprisingly common problem on this edition of PEMCurrents, the Pediatric Emergency Medicine Podcast.

Podcast: Play in new window | Download (Duration: 8:02 — 11.2MB)

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Categories
gastroenterology Podcast Respiratory

Swallowed Foreign Bodies

Kids eat stuff they’re not supposed to. Most of the time foreign bodies pass harmlessly through the GI tract. Occasionally they will get stuck. It is your job to figure out who has an impacted foreign body, and how to diagnose and manage it.

Check out more Pediatric Emergency Medicine content at PEMBlog.com

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Podcast: Play in new window | Download (Duration: 14:20 — 19.9MB)

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