Unusual clinical course, Challenging differential diagnosis
Rachel Appelbaum, Thomas Nowakowski, Angie Zhang, Paul B. Cesanek, Scott Beman, T. Daniel Harrison
(Department of Surgery, Lehigh Valley Health Network, Allentown, PA, USA)
Am J Case Rep 2019; 20:1189-1194
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 REPORT: 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.
Keywords: Abdominal Pain, Eating, Foreign Bodies