Grill Brush Bristle Case Series: Three Unique Presentations of Ingested Foreign Bodies.

BACKGROUND Much of the medical literature regarding injury from the ingestion of wire bristles from grill brushes has been published only in the last decade. Grill brushes are often used to clean grills, and small wire bristles may break off of the brush during the scrubbing process and subsequently become embedded into food and are accidently ingested. Fewer reports have been published on abdominal presentations with injuries past the gastroesophageal sphincter, yet perforation and subsequent need for operative management has been shown to be more prevalent in these types of cases. CASE REPORT Herein, we report on 3 unique cases of accidental ingestion of grill brush wire bristles. Case 1 involved a 55-year-old male who presented to the Emergency Department (ED) for evaluation after experiencing 2 days of abdominal pain while working in the yard. He was found to have a small bowel perforation secondary to a metallic foreign body. Case 2 involved a 61-year-old female who presented to the ED with gradual-onset, sharp epigastric pain radiating to her right side. She was found to have a fistula between her stomach and gallbladder secondary to a contained perforation with a metallic foreign body. Case 3 involved a 41-year-old male who presented to the ED after known ingestion of a grill brush bristle. He was found to have a small metallic foreign body protruding into the abdominal wall. CONCLUSIONS To avoid these injuries, there must be increased awareness among consumers, manufacturers, retailers, and medical professionals to promote prevention, timely diagnosis, and appropriate treatment.

Incidence of general surgical procedures in adult patients on extracorporeal membrane oxygenation.

PURPOSE: Extracorporeal membrane oxygenation use may predispose patients to developing conditions that require either consultation with a general surgeon or a general surgical procedure. We aimed to evaluate the incidence and outcomes of adult extracorporeal membrane oxygenation patients who underwent general surgical procedure. METHODS: This was a single institution retrospective study of adult extracorporeal membrane oxygenation patients from 2012 to 2015. Outcomes were compared between patients who underwent general surgical procedure with those that did not. RESULTS: Of the 115 patients, 54 (46.9%) required a general surgeon while 42 (36.5%) required a general surgical procedure. No significant differences were observed in mortality (35.7% vs. 46.6%; p = 0.256) and extracorporeal membrane oxygenation-related complications (45.7% vs. 32.5%; p = 0.175). Patients with general surgical procedure had longer extracorporeal membrane oxygenation duration (13 vs. 5 days; p < 0.0001), longer length of stay (36 vs. 15 days; p = 0.0005), more wound infections (19.05% vs. 5.5%; p = 0.029), more urinary tract infections (38.1% vs. 10.96%; p = 0.0006), and more pulmonary emboli (19.05% vs. 5.48%; p = 0.029). In general surgical procedure patients, no difference in bleeding complications was observed regardless of anti-coagulation status (29.4% vs. 16%; p = 0.44). CONCLUSION: Common general surgical procedures are safe and feasible in adult extracorporeal membrane oxygenation patients. Duration of extracorporeal membrane oxygenation was longer for patients requiring general surgical procedure. Despite the common use of anticoagulants, there was no increase in bleeding events in general surgical procedure patients.