The role of ultrasonography in the imaging of body packers comparison with CT: a prospective study

Çengel, Ferhat; Bulakçı, Mesut; Selcuk, Tuba; Savas, Yildiray; Ceyhan, M; Koçak, Ayhan; Bilgili, Cigdem

doi:10.1007/s00261-015-0430-z

Cited by 19 publications

(27 citation statements)

References 16 publications

(44 reference statements)

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“…A negative ultrasonography cannot rule out the diagnosis of body packing. However, it may be preferred as the initial imaging method or for follow-up of suspected cases as a radiation-free, easy-to-use, and inexpensive technique [71]. Magnetic resonance imaging (MRI) is rarely used as first-line emergency modality because of its high costs and limited availability.…”

Section: Ultrasound and Mrimentioning

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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Section: Ultrasound and Mrimentioning

confidence: 99%

Imaging of body packing: errors and medico-legal issues

et al. 2015

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“…In addition, a negative exam does not exclude intracorporal packs that may be disguised by superimposing structures, for example, gas. 25,30 In this case, death did not occur within minutes based on the amount of ineffective metabolites of cocaine. The decompositional changes and the musculature sample obtained instead of blood did not allow further precision.…”

Section: Discussionmentioning

confidence: 78%

Death by “Snow”! A Fatal Forensic Case of Cocaine Leakage in a “Drug Mule” on Postmortem Computed and Magnetic Resonance Tomography Compared With Autopsy

Flach¹,

Gascho²,

Fader³

et al. 2017

Am J Forensic Med Pathol

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This forensic case presents unique postmortem imaging of a "drug mule" with fatal intoxication due to cocaine leakage on postmortem computed and magnetic resonance (MR) tomography compared with autopsy.Imaging by postmortem computed and MR tomography was performed before autopsy, histology, and toxicology were commissioned. Forensic imaging revealed 91 hyperdense, uniformly shaped body packs with signs of leakage, which was confirmed by autopsy. Postmortem MR imaging displayed the rarely described hypointense appearance of the body packs in T1- and T2-weighted sequences. Toxicology stated the dosage of cocaine intoxication as lethal.This case provides an opportunity to image internal cocaine drug containers on postmortem computed and MR tomography. The cause of death could be determined based on imaging and the radiological morphology of these packs by both imaging methods.

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“…Although ultrasonography has been used in the diagnostic assessment of body packers for years, the literature knowledge of this subject is still limited. 23,[30][31][32] Ultrasonography can be used as the first choice in the detection of intestinal obstruction secondary to packages and intra-abdominal free fluid. 12 Furthermore, it has been reported that an intravaginal package was detected in a suspect using sonography.…”

Section: Ultrasonographymentioning

confidence: 99%

“…The authors reported that abdominal ultrasonography was a valuable method with results available within minutes, one that could be used as a screening method to detect suspected cases of body packing at airports. 30 Cengel et al 32 in a recent study, in which ultrasonography and CT were compared, reported that ultrasonography had a sensitivity and specificity of 91% and 70%, respectively. Ultrasonography accurately predicted the presence and absence of packages in 39 of 45 suspects.…”

Section: Ultrasonographymentioning

confidence: 99%

“…Ultrasonography accurately predicted the presence and absence of packages in 39 of 45 suspects. 32 Packages that contain drugs in solid form are visualized as multiple, immobile, smooth-contoured, ovoid, hyperechogenic masses in intestinal lumen. Another distinctive feature of packages is that they cause strong posterior clean shadowing.…”

Section: Ultrasonographymentioning

confidence: 99%

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The role of radiology in diagnosis and management of drug mules: an update with new challenges and new diagnostic tools

Bulakçı

Çengel

2016

BJR

Self Cite

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Emergency physicians and radiologists have been increasingly encountering internal concealment of illegal drugs. The packages commonly contain powdered solid drugs such as cocaine, heroin, methamphetamine and hashish, but they may also contain cocaine in the liquid form. The second type of package has recently been more commonly encountered, and poses a greater diagnostic challenge. As clinical evaluation and laboratory tests frequently fail to make the correct diagnosis, imaging examination is typically required. Imaging methods assume a vital role in the diagnosis, follow-up and management. Abdominal X-ray, ultrasonography, CT and MRI are used for the imaging purposes. Among the aforementioned methods, low-dose CT is state-of-the-art in these cases. It is of paramount importance that radiologists have a full knowledge of the imaging characteristics of these packages and accurately guide physicians and security officials.

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The role of ultrasonography in the imaging of body packers comparison with CT: a prospective study

Cited by 19 publications

References 16 publications

Imaging of body packing: errors and medico-legal issues

Imaging of body packing: errors and medico-legal issues

Death by “Snow”! A Fatal Forensic Case of Cocaine Leakage in a “Drug Mule” on Postmortem Computed and Magnetic Resonance Tomography Compared With Autopsy

The role of radiology in diagnosis and management of drug mules: an update with new challenges and new diagnostic tools

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