With spring almost here, it’s time to start barbecuing again. It may be one of our few diversions if we are still staying home. Before you get out that wire brush to clean off last year’s grill mess, read this.

An estimated 140 cases of grill brush wire bristles breaking off and being ingested occur each year. Most are lodged in the pharynx or esophagus, but some may end up further down the gastrointestinal tract. Here are a few examples.

Figure 1

A 61-year-old woman had gradual onset of epigastric pain radiating to the right abdomen and nausea. There were no other symptoms. She was tender in the right upper abdomen. A CT scan showed a metallic object in the space between the stomach and gallbladder with signs of inflammation. She was treated conservatively and discharged, but a follow-up CT scan showed the object had moved and looked like it was lodged in the gallbladder wall. See figure 1.

 

Figure 2

At laparoscopy, a fistulous tract between the gastric antrum and the gallbladder was identified. See figure 2. The gallbladder was removed and a brush wire was found in its wall. She was discharged on the date of surgery.

 

 

Figure 3

A 58-year-old man with an unremarkable past medical history presented to a gastroenterologist because of halitosis which persisted despite optimal dental care. He underwent upper gastrointestinal endoscopy. A metallic foreign body was embedded in the wall of the duodenum. See figure 3. The wire was removed and the halitosis resolved.

Figure 4

A 55-year-old man went to an emergency department because of a two-day history of generalized abdominal pain which was sharp and intermittent. He did not have signs of peritonitis. A CT scan showed an inflamed loop of small bowel in the upper abdomen with a possible foreign body. At surgery, a piece of wire protruding from the intestinal wall was found and removed. See figure 4. He went home the next day.

Figure 5

A 75-year-old woman had abdominal pain and recalled eating a steak cooked on a grill. A CT scan showed a metallic object in a liver abscess. See figure 5. She underwent a laparotomy and a partial hepatectomy and was discharged after a 6-day postoperative stay.

Figure 6

A 16-year-old girl was referred to an emergency department after an x-ray showed a foreign body in the abdomen. She had a history of pain after eating grilled food. A CT scan showed the foreign body in the abdominal wall adjacent to the ascending colon. It must have gradually worked its way through the wall of the bowel. See figure 6. She underwent laparoscopy and removal of the wire and did well.

What can you do to prevent these injuries? Consumer Reports recommends the following. Clean your grill with something other than a wire grill brush, such as a grill stone or even a wad of aluminum foil. A liquid grill cleaner can help soften adherent food debris. If you must use a wire grill brush, make sure it is not worn out. If it is missing any bristles, toss it.

 

Skeptical Scalpel is a retired surgeon and was a surgical department chair and residency program director for many years. He is board-certified in general surgery and a surgical sub-specialty and has re-certified in both several times.For the last 9 years, he has been blogging at SkepticalScalpel.blogspot.com and tweeting as @SkepticScalpel. His blog has had more than 3,700,000 page views, and he has over 21,000 followers on Twitter.