Risk of Barbecuing ;gastric perforation

   Risk of Barbecuing ;gastric perforation

Ref

 J Surg Case Rep. 2025 Nov 4;2025(11):rjaf877. doi: 10.1093/jscr/rjaf877

Two rare cases of gastric perforation caused by ingested metal bristle: the risk of barbecuing

Amjad Mallisho 1,b, Theodora Dionysopoulou 2,b, Greta Kessler 3, Michael Drew Honaker 4, Andres Heigl 5, Anas Taha 6,7,8,✉, Robert Rosenberg 9, Reinhard Stoll 10,c, Jasmin Zeindler 11,12

Gastrointestinal perforation from ingested foreign bodies remains an uncommon but potentially serious complication, seen in <1% of ingestion cases [1].

 While sharp objects such as toothpicks, fish bones, and grill wire bristles are more likely to cause perforation, their diagnosis is frequently delayed due to the absence of a clear ingestion history [2].

The stomach is an unusual site for perforation due to its thick muscular wall and spacious lumen. However, posterior wall perforations are particularly difficult to detect as they may lead to retroperitoneal, lesser sac involvement or liver abscesses without generalized peritonitis and unspecific symptoms [3].

CT imaging played a critical role in these cases, both in initial detection and in identifying positional change, which raised suspicion for perforation and mesenteric migration [4]. As emphasized in ESGE guidelines, persistent symptoms despite negative endoscopy or laparoscopy should prompt further imaging and potential reintervention [9].

Intraoperatively, direct access to the lesser sac allowed visual confirmation and safe extraction [10]. Literature supports laparoscopic over open retrieval when technically feasible, offering better visualization and reduced morbidity [11].

A growing number of cases implicate grill-cleaning wire bristles as culprits in gastrointestinal injuries. These bristles are often ingested unknowingly and can migrate to the liver, pancreas, or mesentery, sometimes causing abscesses or sepsis [12]. Some authors even advocate for banning these wire bristles to avoid these kinds of complications [12].

These cases exemplify the importance of multidisciplinary persistence in managing obscure abdominal pain with atypical imaging findings [13]. Delays in localization may require multiple modalities and re-evaluation. Furthermore, it highlights the need for increased public awareness about the dangers of wire-bristle ingestion [14].

Conclusion

These two cases highlight the diagnostic and therapeutic challenges of gastric perforations caused by ingested foreign bodies, particularly difficult-to-detect metal bristles from grill brushes. Despite nonspecific clinical findings and inconclusive initial endoscopy in one case, persistent CT imaging and subsequent laparoscopic exploration ultimately enabled successful management.