Comment on retrieving multiple magnetic foreign bodies from the glottic entrance and stomach: A case report.

Sir,

I read with great interest the article titled “Retrieving multiple magnetic foreign bodies from the glottic entrance and stomach: A case report.” I commend the authors on the meticulous management of the case. Ingestion of sharp items, batteries, and multiple magnets presents a possibility of intestinal perforation or ileus. When a magnet is brought to a piece of iron, the iron is drawn to the magnet as it has the same tendency to draw other parts of iron; the same principle was used with the help of steel Magill forceps in retrieving foreign body kept anterior to the epiglottis and on the right arytenoid.[1] According to the authors, swallowed beads were recovered “in block” using an endoscopic retrieval basket. Half of the beads had already passed into the duodenum at this stage. Any pause may have rendered the endoscopic solution more complex and may have needed surgical care.[1]

Endoscopic extraction systems are used for the removal of foreign items, polyps, and esophageal food impacts. Various forms of snares, baskets, forks, nets, and graspers are currently prevalent although the option relies primarily on the form and length of the retrieved item. The endoscopic retrieval basket used in the case consists of several wires that make it possible to grab those items relative to a snare. However, baskets' material is constructed in soft (braided wire) and rough (solid wire) configurations.[2] On the other hand, magnetic retrievers, composed of large, versatile cables attached to a solid magnet, are often used specifically to recover ferromagnetic foreign items.[2] Metallic biopsy forceps are other options usually available that are used in endoscopes to remove items.[2] In this particular case, the property of iron to attract and capture magnets could also have been utilized for gastrointestinal foreign bodies. The use of a metallic capturing device such as metallic biopsy forceps or magnetic retrievers could also have prevented possible advancement in the duodenum as had happened in this case. To conclude, metal objects are ideal for dragging foreign magnetic bodies and vice versa.

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