Complicated acute appendicitis? An unusual differential

Cawich, Shamir O; Hassranah, Dale; Pooran, Suresh; Dan, Dilip; Narayansingh, Vijay

doi:10.1177/0049475514550064

Cited by 6 publications

(2 citation statements)

References 14 publications

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“…About 90% of patients gave inaccurate histories—not surprising since patients with RFBs are known to be deceptive historians ( Cawich et al, 2010 ; Cawich, Hassranah, et al, 2014 ; Cawich, Williams, Evans, & Johnson, 2008 ; Cologne & Ault, 2012 ; Kasotakis et al, 2012 ). Patient 7 presented with peritonitis and was not forthcoming even in the face of a life-threatening complication.…”

Section: Discussionmentioning

confidence: 99%

A Management Algorithm for Retained Rectal Foreign Bodies

et al. 2016

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Few authors have proposed therapeutic protocols to manage retained rectal foreign bodies (RFBs). All patients with retained RFBs in hospitals across Trinidad and Tobago over 5 years were identified. Hospital records were retrieved and manually reviewed to extract the following data: demographics, history, foreign body retrieved, clinical signs at presentation, management strategy, duration of hospitalization, and morbidity and mortality. There were 10 patients with RFBs over the study period. The annual incidence of this phenomenon was 0.15 per 100,000 population. All patients were men at a mean age of 50.6 years (range: 27-83; SD = 15.3) who presented after a voluntary delay of 1.4 days (range: 0.5-2.5; SD = 0.7). Only one patient gave an accurate history on presentation, but all eventually admitted to self-insertion for sexual gratification. At presentation, one patient had a spontaneous rectal perforation (10%). The remaining nine patients had attempts at bedside transanal extraction, which was unsuccessful in 89% (8/9) of cases. The RFB was pushed beyond the grasp of forceps, making removal under anesthesia unsuccessful in 62.5% (5/8) cases. These patients required more invasive extraction methods including transanal minimally invasive surgery (1), laparoscopic-assisted advancement with transanal retrieval (1), and open surgery with transmural extraction and anastomoses (3). A management algorithm is proposed for the management of RFBs. Important points in this algorithm are the importance of clinician–patient rapport, early surgical referral, avoidance of bedside extraction in the emergency room, early examination under anesthesia, and the inclusion of emerging therapies such as transanal minimally invasive surgery.

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Section: Discussionmentioning

confidence: 99%

A Management Algorithm for Retained Rectal Foreign Bodies

et al. 2016

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“…Les body-packers peuvent aussi être identifiés suite à la survenue de complications. On distingue les complications mécaniques (obstruction intestinale) des complications toxiques suite au passage systémique de la drogue (épilepsie, arrêt cardiaque, détresse respiratoire, rhabdomyolyse, insuffisance rénale aiguë) provoqué par la fuite ou la rupture du paquet [16]. Une fois arrêtés par les forces de l'ordre, ils sont la plupart du temps amenés à la section médicale ou médicojudiciaire de l'aéroport.…”

Section: Diagnosticunclassified

Prise en charge desbody-packers

Schmit

Abdallah

Vanhaebost

et al. 2018

Méd. Intensive Réa.

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>Aujourd’hui, le body-packing ou transport in corpore de substances illicites est le mode de transport de drogues le plus répandu en Europe. Il porte essentiellement sur la cocaïne et l’héroïne, bien que toute autre substance puisse être concernée dans une moindre mesure. Les passeurs (« mules ») sont identifiés par les services de police et de douane sur la base de plusieurs indices permettant de les suspecter, comme l’origine des vols long-courriers, l’abstinence alimentaire, etc. La sensibilité du dépistage urinaire et le diagnostic reposent essentiellement sur l’imagerie abdominale, de préférence l’examen tomodensitométrique lorsqu’il est disponible. Les passeurs sont ensuite placés sous surveillance médicale. Celle-ci n’est pas standardisée, mais devrait durer au moins six heures, avec une attention particulière aux paramètres hémodynamiques et neurologiques. Le risque de rupture des paquets est principalement lié à la qualité de l’emballage. Le traitement est essentiellement conservateur. Les complications restent rares, et le recours à la chirurgie s’avère nécessaire en cas de signes d’intoxication et/ou d’occlusion digestive.

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Systematic review of the toxicological and radiological features of body packing

et al. 2016

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Body packing is the term used for the intracorporeal concealment of illicit drugs, mainly cocaine, heroin, methamphetamine, and cannabinoids. These drugs are produced in the form of packages and are swallowed or placed in various anatomical cavities and body orifices. Basing on these two ways of transportation a distinction between body stuffers and body pushers can be made, with the former described as drug users or street dealers who usually carry small amounts of drugs and the latter as professional drug couriers who carry greater amounts of drugs. A review of the literature regarding body packing is presented, with the aim to highlight the toxicological and radiological features related to this illegal practice. Raising awareness about the encountered mean body levels of the drugs and the typical imaging signs of the incorporated packages could be useful for clinicians and forensic pathologists to (a) identify possible unrecognized cases of body packing and (b) prevent the serious health consequences and deaths frequently occurring after the packages' leakage or rupture or the packages' mass obstructing the gastrointestinal lumen.

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Complicated acute appendicitis? An unusual differential

Cited by 6 publications

References 14 publications

A Management Algorithm for Retained Rectal Foreign Bodies

A Management Algorithm for Retained Rectal Foreign Bodies

Prise en charge desbody-packers

Systematic review of the toxicological and radiological features of body packing

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