Contrast CT scan fails to detect the last heroin packet

Hahn, In‐Hei; Hoffman, Robert S.; Nelson, Lewis S.

doi:10.1016/j.jemermed.2004.04.012

Cited by 39 publications

(25 citation statements)

References 13 publications

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“…12 However, one study reported a false negative. 13 CT is also useful for the identification of any associated complications, such as intestinal obstruction or perforation, but is not appropriate as a screening tool due to the excessive ionising radiation burden. Another alternative method is contrast-enhanced abdominal radiography with water-soluble contrast agents, which may identify drug packets as filling defects within the contrast medium.…”

Section: Discussionmentioning

confidence: 99%

Abdominal X-ray signs of intra-intestinal drug smuggling

Niewiarowski

Gogbashian

Afaq

et al. 2010

Journal of Forensic and Legal Medicine

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Section: Discussionmentioning

confidence: 99%

Abdominal X-ray signs of intra-intestinal drug smuggling

Niewiarowski

Gogbashian

Afaq

et al. 2010

Journal of Forensic and Legal Medicine

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“…7A-D). An insufficient air-hyperdense rim around the packets and a combination of high density with regular bowel contents are suggestive of ruptured packets [72][73][74][75]. CT has also been used experimentally to determine the contents of packets on the basis of differences in the HU: cocaine had a rate of -219 HU and heroin had a rate of -520 HU (Fig.…”

Section: Computed Tomographymentioning

confidence: 99%

Imaging of body packing: errors and medico-legal issues

et al. 2015

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Body packing is the ingestion or insertion in the human body of packed illicit substances. Over the last 20 years, drug smuggling has increased global and new means of transport of narcotics have emerged. Among these, the most frequent one is the gastrointestinal tract: from mouth to anus, vagina, and ears. Cocaine is one of the most traded drugs, followed by heroin. Condoms, latex gloves, and balloons are typically used as drug packets for retention in the body. There are different radiologic modalities to detect illicit drugs in body packing: Plain radiography, computed tomography (CT), ultrasound, and magnetic resonance. Current protocols recommend the use of radiography to confirm packet retention and, in case of doubt, the use of abdominal CT scan with reduced mAs. In case of packet rupture, catastrophic effects can occur. Management of patients carrying packets of drugs is a recurrent medico-legal problem. To improve diagnostic accuracy and prevent hazardous complications, radiologists and emergency physicians should be familiar with radiologic features of body packing. The radiologist plays both a social and a medico-legal role in their assessment, and it should not be limited only to the identification of the packages but must also provide accurate information about their number and their exact location. In this review, we focus on diagnostic errors and medico-legal issues related to the radiological assessment of body packers.

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“…Compared to plain radiographs and ultrasound, a CT scan generally has higher diagnostic sensitivity for identifying drug packets, although a negative test does not absolutely exclude an ingestion. 42,43 The clinical scenario would determine whether an abdominal CT is necessary in such cases. Consultation with a medical toxicologist or regional poison control center would also be prudent.…”

Section: Computed Tomography (Ct)mentioning

confidence: 99%