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A postmenopausal woman in her mid-50s (gravida 2, aborta 2) with a known history of endometriosis and adenomyosis presented to the emergency department with severe abdominal pain that she rated 10 of 10 in intensity and which had developed suddenly 5 days before presentation. The abdominal pain was associated with diarrhea, nausea, and abdominal bloating. On examination, the patient was afebrile and her abdomen was soft and nondistended without guarding or rebound but tender in the left lower quadrant. The patient had a palpable nodule in the posterior vaginal fornix and fullness in the left lower quadrant of the abdomen on bimanual examination.
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C. Perforation by foreign bodies
In the Figure, arrowheads indicate the presence of metal brush filaments in the omentum caudal to the transverse colon and in the cul-de-sac adjacent to the upper rectum. There is the potential that metal bristles of barbeque brushes may be dislodged, adhere to food on the grill, and be ingested. If ingested, the metal bristles may cause injury to and/or perforate the gastrointestinal tract, which can lead to severe complications.1- 5 Health Canada, the Centers for Disease Control and Prevention, and the media have made an effort to report cases of injury and inform the public of this problem.3,6,7 However, it is also important that physicians are aware of the clinical presentation, radiologic findings, and management options associated with injuries related to ingested metal barbeque brush bristles to ensure that patients with such injuries receive efficient diagnosis and treatment, especially in the summer months during barbeque season.
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Corresponding Author: Sukhbir S. Singh, MD, FRCSC, Department of Obstetrics and Gynecology, The Ottawa Hospital, University of Ottawa, 1967 Riverside Dr, 7th Floor, Ottawa, ON K1H 7W9, Canada (firstname.lastname@example.org).
Published Online: July 11, 2018. doi:10.1001/jamasurg.2018.2016
Conflict of Interest Disclosures: Dr Singh reports having participated in a speakers bureau and receiving research grants and consulting fees from Bayer Pharma, Allergan, and AbbVie and having received consulting fees from Cooper Surgical. No other disclosures are reported.
Additional Contributions: We thank the patient for granting permission to publish this information. Carolyn Nessim, MD, FRCSC (Division of General Surgery, Department of Surgery, The Ottawa Hospital, University of Ottawa), was involved in the patient’s care, provided content expertise, and assisted with preparation of the manuscript; she received no compensation for her contribution.
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