Crack cocaine users often employ makeshift filters in their pipes, commonly using steel wool scouring pads like Brillo. While seemingly innocuous, this practice carries a risk of foreign body aspiration or ingestion. This report details an unusual case of a 34-year-old female who presented to the emergency department after inadvertently ingesting a Brillo pad filter while smoking crack cocaine.
The patient arrived seven hours post-exposure, complaining of a burning throat, foreign body sensation, and voice changes. She reported consuming alcohol and smoking crack, expressing concern about inhaling the “screen” from her pipe, described as a fingertip-sized piece of Brillo. Despite these symptoms, she denied experiencing difficulty breathing, swallowing, or abdominal pain.
Physical examination revealed an elevated pulse and respiratory rate, tearfulness, and a whispered voice. While no oropharyngeal burns were visible and lung auscultation was clear, intermittent inspiratory stridor was noted. Oxygen saturation remained within normal limits, and the patient’s blood alcohol content was elevated. Initial assessments, including indirect laryngoscopy, lateral neck x-ray, and chest x-ray, were unremarkable.
Fiberoptic laryngoscopy subsequently revealed edema and swelling of the left posterior arytenoid. Crucially, an abdominal x-ray identified a foreign body in the right lower quadrant, consistent with the ingested Brillo pad filter. Fortunately, the patient’s symptoms resolved overnight, and she was discharged the following morning without complications.
This case highlights a rare but potential complication of Filtered Crack cocaine use: the aspiration and/or ingestion of filter material. While aspiration of crack pipe screens is infrequently reported, physicians should be aware of this possibility and consider it in patients presenting with relevant symptoms and a history of crack cocaine use. Prompt diagnosis through imaging studies, such as abdominal x-rays, is essential for appropriate management. Although this patient recovered without sequelae, the potential for more serious complications underscores the importance of recognizing this unusual presentation.
