Something not so tasty in your barbecue — brush debris

Posted on July 4, 2012 by

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Foreign object ingestion is a common reason for visiting an emergency department (ED), particularly for children (1–3), according to the CDC. In recent years, internal injuries have been reported following unintentional ingestions of wire grill-cleaning brush bristles by both children and adults (4–6). A series of six cases from a single hospital system with two EDs during July 2009–November 2010 was reported previously (4). This report describes a series of six more cases identified at the same hospital system during March 2011–June 2012. The six patients ranged in age from 31 to 64 years; five were men. Like the patients in the previous series (4), all six reported outdoor residential food grilling and use of commercially available wire grill-cleaning brushes. The severity of injury ranged from puncture of the soft tissues of the neck, causing severe pain on swallowing, to perforation of the gastrointestinal tract requiring emergent surgery. Awareness of this potential injury among health-care professionals is critical to facilitate timely diagnosis and treatment. Additionally, awareness among the public, manufacturers who make wire grill-cleaning brushes, and retailers who sell these products can reduce exposures and decrease the likelihood of further occurrences. Before cooking, persons should examine the grill surface carefully for the presence of bristles that might have dislodged from the grill brush and could embed in cooked food. Alternative residential grill-cleaning methods or products might be considered.

The first of the six most recent cases was identified on March 14, 2011, and the latest on June 3, 2012. Medical staff members continue to conduct surveillance for additional cases of injury from ingested wire grill-cleaning brush bristles treated in the hospital system.

Case Reports

A man aged 50 years arrived at the ED with abdominal pain that had begun after eating steak at a backyard barbeque. Computed tomography (CT) scan of the abdomen and pelvis revealed a linear object extending through the wall of a loop of small intestine into the omentum (Figure). Laparotomy was performed to remove the foreign body, which appeared to be a wire bristle from a grill-cleaning brush. The patient fully recovered and was discharged the next day.

Five more patients visited the ED during August 2011–June 2012 after inadvertent ingestion of a wire bristle that had become dislodged from a grill-cleaning brush and embedded in food. In all of the cases, the bristles were initially identified by radiographs of the neck or CT scans of the abdomen and pelvis, and their origin was confirmed after removal (Table). Patient interviews revealed a common history of recent ingestion of grilled meat. After definitive treatment, all six patients recovered fully.

Severe pain on swallowing was the chief symptom in three of the six patients. In all three of these patients, a wire bristle from a grill-cleaning brush was found in the neck. The three included a woman aged 46 years and two men aged 50 and 64 years (Table). The three initially were evaluated with plain radiography, which identified the foreign object in each patient. One who was initially evaluated with plain radiography then underwent CT for precise localization. All three were treated successfully with laryngoscopic removal of the wire bristle.

Severe abdominal pain was the chief symptom of the other patients, who were three men aged 31, 35, and 50 years (Table). These patients were evaluated primarily with intravenous contrast-enhanced CT of the abdomen and pelvis. In two patients, the wire bristle was noted lodged within the omentum adjacent to a loop of small intestine. In one patient, the wire bristle was located within the sigmoid colon, indenting the bladder. Two patients underwent emergency abdominal surgery to retrieve the foreign object and repair the intestine. In one patient, the wire had not perforated the intestine and was removed via colonoscopy.

Posted in: Family safety