A 56 uo. male was eating a large piece of barbecued chicken 2 days pta and co pain with swallowing after eating. He was able to take in liquids and soft solids and waited two days before seeking medical attention. What do you see?
Our patient had swallowed a grill brush bristle. This is actually not unusual. In a recent study; the Epidemiology of Wire-Bristle Grill Brush injury in the United States, 2002-14 1698 cases were reported nationwide that arrived in Emergency Departments.
According to the CDC 80,000 people come to emergency rooms every year after accidentally swallowing foreign objects with the majority being children. Wire bristles from grill cleaning brushes are one of the hardest to detect because the bristles are so thin they may not show up on xray.
The wire bristles most often lodge in the upper digestive tract but have caused gastric and intestinal perforations and in one case, death.
Teaching point: Ask what your patient was eating before the abdominal pain started.
Our patient had a CT scan showing the wire and was started on antibiotics. GI scoped him and removed the wire. A swallow showed no perforation of the esophagus and he recovered uneventfully.
Baugh TP, Hadley J, Chang CW. Epidemiology of Wire-Bristle Grill Brush Injury in the United States, 2002-2014. Otolaryngol Head Neck Surg April 2014 vol. 154(4); 645-649.
Arganbright JM, Bruegger DE, Sykes KJ, Wei JL Wire grill brush bristle as an unusual foreign body: report of two pediatric cases. Laryngoscope 2012. Mar 122 (3) 685-7.
Anish Nihalani A, Cudworth M. Successful Laparoscopic management of the gastric perforation due to grill brush wire bristle. SAGES( Society of American Gastrointestinal and Endoscopic Surgeons Meeting2014. Poster
Chen MK, Belerle EA. Gastrointestinal foreign bodies. Pediatr Ann 2001;30:736-42.
Consumer Product Safety Commission. National Electroni Injury Surveillance System . Washington DC: Consumer Product Safety Commission; 2012. Available at http://www.cpsc.gov/library/neiss.html