# 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.

## Key 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.