Small bowel perforation from grill brush bristle

Case contributed by Michael P Hartung
Diagnosis certain

Presentation

Right abdominal pain.

Patient Data

Age: 35 years
Gender: Male

Very subtle curvilinear density in the wall of the small bowel of the right mid abdomen, with mild focal wall thickening and subtle surrounding inflammation. 

Annotated images

Circle indicates the location of small bowel perforation and thin foreign body. 

Intraoperative photo

Intraoperative photo showing thickening, inflammation, and purulence of the involved small bowel loop. The second photos more clearly shows the grill brush bristle protruding from the wall before removal. 

Case Discussion

Highly alarming case of small bowel perforation due to grill brush bristle. The finding is almost imperceptibly subtle, yet fortunately the radiologist detected the inflammation and focal thickening of the small bowel loop and suspected a small foreign body such a fish bone or grill brush bristle. The patient proceeded to surgery to have this foreign body removed. 

Grill brush bristle ingestion can occur from cleaning a grill and having the small bristles fall off the brush and become lodged into the meat on the grill and unknowingly ingested. 

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