Wire Grill Brush Bristles Pose Unexpected Danger

Should be considered for patients presenting with odynophagia or abdominal pain after grilled food

FRIDAY, April 6 (HealthDay News) -- For patients presenting with odynophagia or abdominal pain, physicians should consider the possibility of inadvertent wire brush bristle ingestion after eating grilled meat, according to a report published in the April issue of the American Journal of Roentgenology.

David J. Grand, M.D., of the Warren Alpert School of Medicine at Brown University in Providence, R.I., and colleagues reported on six patients over an 18-month period who presented with odynophagia or abdominal pain within 24 hours of eating grilled meat.

From a careful history, the authors found that all six patients had eaten grilled meat directly after a metallic brush had been used to clean the grill and had inadvertently ingested a wire brush bristle. Of those presenting with odynophagia as a primary symptom, the bristles were observed using radiography of the neck in two patients and using a computed tomography (CT) scan in a third patient. In the three remaining patients who presented with abdominal pain, CT scans were used to identify the wire bristles. Small intestinal perforation occurred in two of the patients, and the third patient experienced perforation of the stomach and liver and development of a large hepatic abscess.

"We do not routinely administer oral contrast agent in the emergency department; however, it should specifically be avoided when there is suspicion of foreign body, because hyperattenuating oral contrast agent can potentially obscure a radiopaque foreign body," the authors write. "This clinical scenario needs to be considered by physicians whenever patients present with acute pain after ingestion of grilled food."

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