The cocaine ′body-packer′ syndrome: Diagnosis and treatment

Khan, Fahmi Yousef

doi:10.4103/0019-5359.17054

Cited by 29 publications

(18 citation statements)

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“…After swallowing the drugs, constipating agents such as diphenoxylate or loperamide may be used to extend the travel time. The travel time may alter from 24 h to 3 weeks [17]. After entering the destination section, the smugglers could benefit laxatives to get rid of their packets [18].…”

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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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Imaging of body packing: errors and medico-legal issues

et al. 2015

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“…One method involves swallowing latex balloons (often condoms or fingers of latex gloves) or special pellets filled with the goods and recovering them from the feces later [1][2][3]. Body packing was first described in the medical literature in 1973 [1].…”

Section: Image Of the Issuementioning

confidence: 99%

“…Body packing was first described in the medical literature in 1973 [1]. However, this practice is increasingly common and may have disastrous consequences, including gastrointestinal obstruction or perforation, signs of systemic drug toxicity from a ruptured packet or even death after rupture in 56% of cases [2,3]. If the body packer is asymptomatic, he may need medical evaluation and monitoring for prevention of spontaneous opening of the drug packets.…”

Section: Image Of the Issuementioning

confidence: 99%

“…If the body packer is asymptomatic, he may need medical evaluation and monitoring for prevention of spontaneous opening of the drug packets. The international experience reports that in asymptomatic patients a conservative treatment is enough to help the spontaneous evacuation of packets [2,3]. However, if the Body Packers Syndrome develops suddenly, with anxiety, dilated pupils, diaphoresis, tachycardia and hypertension, followed by hyperthermia, seizures, and cardiovascular collapse, the best treatment is surgical.…”

Section: Image Of the Issuementioning

confidence: 99%

“…However, if the Body Packers Syndrome develops suddenly, with anxiety, dilated pupils, diaphoresis, tachycardia and hypertension, followed by hyperthermia, seizures, and cardiovascular collapse, the best treatment is surgical. Quickness, accuracy and the appropriate use of radiological investigations are the main factors for achieving a correct diagnosis and obtaining a good result [2,3].…”

Section: Image Of the Issuementioning

confidence: 99%

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Cocaine Capsules in the Colon: the Internal Concealment of Illicit Drugs

Trabulo

Marques

Pedroso

2015

JGLD

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A 26 year-old man arrested for presumed drug smuggling was brought to the Emergency Room complaining of diffuse abdominal pain, nausea and bloating for 48 hours. He denied fever, constipation, diarrhea or vomiting. He smoked 20 cigarrettes/day and denied taking any medication or drug. His father had died of colorectal cancer at the age of 40. At physical examination, the patient presented tachycardia (120 bpm), fever (38.2 º C) and diaphoresis. At abdominal examination, he had no abdominal distension and the bowel sounds were normal. He had no palpable masses, organomegalies or signs of peritoneal irritation. Blood pressure was 120/80 mmHg and respiratory rate was 20 cpm, with 98% SatO 2 on oximetry. Cardiac and pulmonary auscultation, as well as the neurological examination were unremarkable. Electrocardiogram revealed sinusal tachycardia. Laboratory studies showed normal white blood cell count, C-reactive protein level, liver and renal function tests. Lipase and troponin-I levels were normal. Fever subsided after 1 g of acetaminophen. An upright abdominal x-ray was performed (Fig.).The plain abdominal X-ray showed numerous hypotransparent nodules in the entire colon, without small or large bowel dilation, pneumoperitoneum or bowel obstruction. The nodules corresponded to the drug capsules the patient had ingested before his arrest. Since there were no signs of severe acute cocaine

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