Grill Brush Bristle Case Series: Three Unique Presentations of Ingested Foreign Bodies

Abstract

Case series Patient: Male, 55 • Female, 61 • Male, 41 Final Diagnosis: Metallic foreign body Symptoms: Abdominal pain Medication: — Clinical Procedure: Diagnostic laparoscopy Specialty: Surgery Objective: Unusual clinical course Background: Much of the medical literature regarding injury from the ingestion of wire bristles from grill brushes has been published only in the last decade. Grill brushes are often used to clean grills, and small wire bristles may break off of the brush during the scrubbing process and subsequently become embedded into food and are accidently ingested. Fewer reports have been published on abdominal presentations with injuries past the gastroesophageal sphincter, yet perforation and subsequent need for operative management has been shown to be more prevalent in these types of cases. Case Reports: Herein, we report on 3 unique cases of accidental ingestion of grill brush wire bristles. Case 1 involved a 55-year-old male who presented to the Emergency Department (ED) for evaluation after experiencing 2 days of abdominal pain while working in the yard. He was found to have a small bowel perforation secondary to a metallic foreign body. Case 2 involved a 61-year-old female who presented to the ED with gradual-onset, sharp epigastric pain radiating to her right side. She was found to have a fistula between her stomach and gallbladder secondary to a contained perforation with a metallic foreign body. Case 3 involved a 41-year-old male who presented to the ED after known ingestion of a grill brush bristle. He was found to have a small metallic foreign body protruding into the abdominal wall. Conclusions: To avoid these injuries, there must be increased awareness among consumers, manufacturers, retailers, and medical professionals to promote prevention, timely diagnosis, and appropriate treatment.

Hazards and Management of Wire Bristle ingestions: A Systematic Review

“…The final 57 studies were included in this review and used for data abstraction. 2-9,12-60 Our PRISMA flowchart is detailed in Figure 1 . Retrospective case series were evaluated with the NICE quality assessment tools (National Institute for Health and Care Excellence), 76 outlined in Table 2 .…”

“…36 The second case occurred after a bristle was initially identified on abdominal CT scan but was conservatively managed and not removed; subsequent MRI for unrelated shoulder pain resulted in acute abdominal pain and bristle migration to the omentum. 58…”

“…Migration locations included posterior oropharyngeal wall, 40 lateral oropharyngeal wall, 17,39 submental space, 50 infrahyoid DN, 28 unspecified subsite of the DN, 43 lumen of alimentary tract, 53 intra‐abdomen, 58 and superficially toward the skin 13 . Notably, 1 of these migrations was identified when a patient had magnetic resonance imaging (MRI) several months after a known retained bristle and subsequently developed abdominal pain 58 . Additionally, there was 1 bristle penetrating the thyroid and protruding from the pyriform sinus 5 .…”

“…A systematic search was performed per the PRISMA literature selection process ( Figure 1 ). 2-9,12-75 Two authors (N.M. and Y.M.) independently searched the literature for relevant articles.…”

“…Laparoscopy was performed 10 times among 10 of 91 patients: 9 bristles primarily presented in the abdomen, 8,24,35,52,59 and 1 was inadvertently swallowed during endoscopy. 58 It was successful 80% (8/10) of the time. Both laparoscopic failures were converted to open procedures, which were successful.…”