Grill Bristle Induced Perforation of the Bile and Pancreatic Ducts Managed by Endoscopic Ultrasound and Endoscopic Retrograde Cholangiopancreatography: A Unique Foreign Body Case

TL;DR

A rare case of a grill brush bristle causing bile and pancreatic duct perforation was successfully treated using endoscopic techniques.

Contribution

This case highlights the rare complication of grill bristle ingestion and the effective use of endoscopic methods for diagnosis and removal.

Findings

Grill brush bristle ingestion can lead to rare penetration of the bile and pancreatic ducts.

Endoscopic ultrasound and endoscopic retrograde cholangiopancreatography are effective for diagnosis and treatment.

The patient recovered without complications after bristle removal.

Abstract

Foreign body ingestion is common, but penetration into the common bile duct (CBD) and pancreas is exceptionally rare. A 74-year-old woman presented with 4 weeks of intermittent left upper abdominal pain and normal laboratory results. Computed tomography showed a linear hypodensity traversing the ampulla and pancreatic duct. Endoscopic ultrasound confirmed a hyperechoic linear object in the CBD. Endoscopic retrograde cholangiopancreatography with sphincterotomy and balloon sweeps revealed a metallic foreign body protruding from the papilla. It was removed using pediatric cold forceps and identified as a grill brush bristle. The patient was discharged without complications and remained asymptomatic at 4 weeks. Grill brush bristle ingestion can rarely result in CBD and pancreatic duct penetration. Endoscopic ultrasound facilitates localization, and endoscopic retrograde cholangiopancreatography provides a safe, minimally invasive treatment.

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