Research Article
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Diagnostic Parameters for Body Packers

Year 2023, Volume: 13 Issue: 1, 51 - 56, 26.04.2023

Kemal Şener Ertuğrul Altuğ Nazife Didem Hanoğlu Gökhan Eyüpoğlu Ramazan Güven

Abstract

Aim: We aimed to present our experience about the cases brought with the suspicion of body packing and our algorithm to diagnose those cases.
Material and Method: Our study was conducted with 47 of 55 patients brought to the emergency department of our tertiary care hospital by the narcotic police from a major airport in our city with the suspicion of carrying a substance in their bodies.
Results: Computed tomography showed the presence and absence of capsules with 100% accuracy. No false positive or false negative results were obtained from any admitted patients. The power of computed tomography to detect both the presence and absence of a capsule is determined as p<0.001 according to the statistical analysis
Conclusion: In our study, it is seen that the most appropriate imaging method for diagnosing patients brought to the emergency room due to substance carrying in the body is abdominal noncontrast tomography. Blood tests do not give an absolute result about whether the patient carries substances. Considering all these results, non-contrast abdominal computed tomography is recommended for patients that are brought in with the suspicion of substance carrying in their bodies.

Keywords

body packer computed tomography diagnosis

References

  • 1. Ngatchou W, Lemogoum D, Essola B, Ramadan A, Ngassa M, Guimfacq V, et al. Cannabis body packing: a case report. Pan Afr Med J. 2016;24:327.
  • 2. Özer E, Şam B, Özdeş T, Dokgöz H. Paket vücut sendromuna bağlı kokain intoksikasyonu sonucu ölüm: Olgu sunumu. Adli Tıp Bülteni. 2005 ;10(2):62–5.
  • 3. Shahnazi M, Sanei Taheri M, Pourghorban R. Body packing and ıts radiologic manifestations: A review article. Iran J Radiol. 2011;8(4):205–10.
  • 4. McCarron MM, Wood JD. The cocaine ‘body packer’ syndrome. Diagnosis and treatment. JAMA. 1983;250:1417–20.
  • 5. Sinner WN. The gastrointestinal tract as a vehicle for drug smuggling. Gastrointest Radiol. 1981;6:319–23.
  • 6. Suarez CA, Arango A, Lester JL., III Cocaine-codom ingestion. Surgical treatment. JAMA. 1977;238:1391–92.
  • 7. Wetli CV, Mittlemann RE. The “body packer syndrome”toxicity following ingestion of illicit drugs packaged for transportation. J Forensic Sci.1981;26:492–500.
  • 8. Adem Ç, Ramazan G, Kemal Ş. High-Dose Poisoning, “Body Packers” Case That Ended in An Emergency: A Case Report. Open Acc J of Toxicol. 2021; 5(2):555659.
  • 9. Cappelletti S, Aromatario M, Bottoni E, Fiore PA, Straccamore M, Umani Ronchi F, et al. (2016) Drug-related deaths with evidences of body packing: two case reports and medico-legal issues. Leg Med 20:23-6.
  • 10. de Bakker JK, Nanayakkara PW, Geeraedts LM Jr, de Lange ES, Mackintosh MO, Bonjer HJ. Body packers: a plea for conservative treatment. Langenbecks Arch Surg. 2012;397(1):125–30.
  • 11. Sengupta A, Page P. Window manipulation in diagnosis of body packing using computed tomography. Emerg Radiol. 2008;15(3):203–5.
  • 12. Flach PM, Ross SG, Ampanozi G, Ebert L, Germerott T, Hatch GM, et al. “Drug mules” as a radiological challenge: sensitivity and specificity in identifying internal cocaine in body packers, body pushers and body stuffers by computed tomography, plain radiography and Lodox. Eur J Radiol. 2012;81(10):2518–26.
  • 13. Horrocks AW. Abdominal radiography in suspected ‘body packers’. Clin Radiol. 1992;45(5):322–5.
  • 14. Makoto Nihira, Makiko Hayashida, Youkichi Ohno, Sho Inuzuka, Hiroyuki Yokota, Yasuhiro Yamamoto, Urinalysis of Body Packers in Japan, Journal of Analytical Toxicology, Volume 22, Issue 1, January-February 1998, Pages 61–5. 15. Heymann-Maier L, Trueb L, Schmidt S, Carron PN, Hugli O, Heymann E, et al. (2017) Emergency department management of body packers and body stuffers. Swiss Med Wkly 147:w14499.
  • 16. Booker RJ, Smith JE, Rodger MP. Packers, pushers and stuffers—managing patients with concealed drugs in UK emergency departments: a clinical and medicolegal review Emergency Medicine Journal. 2009;26:316–20.
  • 17. Cordero DR, Medina C, Helfgott A. Cocaine body packing in pregnancy. Ann Emerg Med. 2006;48(3):323–5.
  • 18. Chakrabarty A, Hydros S, Puliyel JM. Images in paediatrics: smuggling contraband drugs using paediatric “body packers”. Arch Dis Child. 2006;91:51.
  • 19. Schaper A, Hofmann R, Bargain P, Desel H, Ebbecke M, Langer C. Surgical treatment in cocaine body packers and body pushers. Int J Colorectal Dis. 2007;22(12):1531–5.
  • 20. Maier Liv, Trueb Lionel, Schmidt Sabine, Carron PierreNicolas, Hugli Olivier, Heymann Eric, et al. Emergency department management of body packers and body stuffers. Swiss Med Wkly. 2017;147:w14499.
  • 21. Bulakci M, Ozbakir B, Kiris A (2013b) Detection of body packing by magnetic resonance imaging: a new diagnostic tool? Abdom Imaging 38(3):436–41.
  • 22. Hergan K, Kofler K, Oser W (2004) Drug smuggling by body packing: what radiologists should know about it. Eur Radiol 14:736–42.
  • 23. Karhunen PJ, Suoranta H, Penttila A, Pitkaranta P (1991) Pitfalls in the diagnosis of drug smuggler’s abdomen. J Forensic Sci 36:397–402.
  • 24. Hierholzer J, Cordes M, Tantow H, Keske U, Mäurer J, Felix R. Drug smuggling by ingested cocaine-filled packages: conventional x-ray and ultrasound. Abdom Imaging 1995;20(4):333–8.
  • 25. Cappelletti S, Piacentino D, Sani G, Bottoni E, Fiore PA, Aromatario M, et al. Systematic review of the toxicological and radiological features of body packing. Int J Legal Med. 2016;130(3):693–709.
  • 26. Hahn IH, Hoffman RS, Nelson LS. Contrast CT scan fails to detect the last heroin packet. J Emerg Med. 2004;27(3):27983.
  • 27. Aldrighetti L, Paganelli M, Giacomelli M, Villa G, Ferla G. Conservative management of cocaine-packet ingestion: experience in Milan, the main Italian smuggling center of South American cocaine. Panminerva Med. 1996;38(2):111–6.

Year 2023, Volume: 13 Issue: 1, 51 - 56, 26.04.2023

Kemal Şener Ertuğrul Altuğ Nazife Didem Hanoğlu Gökhan Eyüpoğlu Ramazan Güven

Abstract

References

  • 1. Ngatchou W, Lemogoum D, Essola B, Ramadan A, Ngassa M, Guimfacq V, et al. Cannabis body packing: a case report. Pan Afr Med J. 2016;24:327.
  • 2. Özer E, Şam B, Özdeş T, Dokgöz H. Paket vücut sendromuna bağlı kokain intoksikasyonu sonucu ölüm: Olgu sunumu. Adli Tıp Bülteni. 2005 ;10(2):62–5.
  • 3. Shahnazi M, Sanei Taheri M, Pourghorban R. Body packing and ıts radiologic manifestations: A review article. Iran J Radiol. 2011;8(4):205–10.
  • 4. McCarron MM, Wood JD. The cocaine ‘body packer’ syndrome. Diagnosis and treatment. JAMA. 1983;250:1417–20.
  • 5. Sinner WN. The gastrointestinal tract as a vehicle for drug smuggling. Gastrointest Radiol. 1981;6:319–23.
  • 6. Suarez CA, Arango A, Lester JL., III Cocaine-codom ingestion. Surgical treatment. JAMA. 1977;238:1391–92.
  • 7. Wetli CV, Mittlemann RE. The “body packer syndrome”toxicity following ingestion of illicit drugs packaged for transportation. J Forensic Sci.1981;26:492–500.
  • 8. Adem Ç, Ramazan G, Kemal Ş. High-Dose Poisoning, “Body Packers” Case That Ended in An Emergency: A Case Report. Open Acc J of Toxicol. 2021; 5(2):555659.
  • 9. Cappelletti S, Aromatario M, Bottoni E, Fiore PA, Straccamore M, Umani Ronchi F, et al. (2016) Drug-related deaths with evidences of body packing: two case reports and medico-legal issues. Leg Med 20:23-6.
  • 10. de Bakker JK, Nanayakkara PW, Geeraedts LM Jr, de Lange ES, Mackintosh MO, Bonjer HJ. Body packers: a plea for conservative treatment. Langenbecks Arch Surg. 2012;397(1):125–30.
  • 11. Sengupta A, Page P. Window manipulation in diagnosis of body packing using computed tomography. Emerg Radiol. 2008;15(3):203–5.
  • 12. Flach PM, Ross SG, Ampanozi G, Ebert L, Germerott T, Hatch GM, et al. “Drug mules” as a radiological challenge: sensitivity and specificity in identifying internal cocaine in body packers, body pushers and body stuffers by computed tomography, plain radiography and Lodox. Eur J Radiol. 2012;81(10):2518–26.
  • 13. Horrocks AW. Abdominal radiography in suspected ‘body packers’. Clin Radiol. 1992;45(5):322–5.
  • 14. Makoto Nihira, Makiko Hayashida, Youkichi Ohno, Sho Inuzuka, Hiroyuki Yokota, Yasuhiro Yamamoto, Urinalysis of Body Packers in Japan, Journal of Analytical Toxicology, Volume 22, Issue 1, January-February 1998, Pages 61–5. 15. Heymann-Maier L, Trueb L, Schmidt S, Carron PN, Hugli O, Heymann E, et al. (2017) Emergency department management of body packers and body stuffers. Swiss Med Wkly 147:w14499.
  • 16. Booker RJ, Smith JE, Rodger MP. Packers, pushers and stuffers—managing patients with concealed drugs in UK emergency departments: a clinical and medicolegal review Emergency Medicine Journal. 2009;26:316–20.
  • 17. Cordero DR, Medina C, Helfgott A. Cocaine body packing in pregnancy. Ann Emerg Med. 2006;48(3):323–5.
  • 18. Chakrabarty A, Hydros S, Puliyel JM. Images in paediatrics: smuggling contraband drugs using paediatric “body packers”. Arch Dis Child. 2006;91:51.
  • 19. Schaper A, Hofmann R, Bargain P, Desel H, Ebbecke M, Langer C. Surgical treatment in cocaine body packers and body pushers. Int J Colorectal Dis. 2007;22(12):1531–5.
  • 20. Maier Liv, Trueb Lionel, Schmidt Sabine, Carron PierreNicolas, Hugli Olivier, Heymann Eric, et al. Emergency department management of body packers and body stuffers. Swiss Med Wkly. 2017;147:w14499.
  • 21. Bulakci M, Ozbakir B, Kiris A (2013b) Detection of body packing by magnetic resonance imaging: a new diagnostic tool? Abdom Imaging 38(3):436–41.
  • 22. Hergan K, Kofler K, Oser W (2004) Drug smuggling by body packing: what radiologists should know about it. Eur Radiol 14:736–42.
  • 23. Karhunen PJ, Suoranta H, Penttila A, Pitkaranta P (1991) Pitfalls in the diagnosis of drug smuggler’s abdomen. J Forensic Sci 36:397–402.
  • 24. Hierholzer J, Cordes M, Tantow H, Keske U, Mäurer J, Felix R. Drug smuggling by ingested cocaine-filled packages: conventional x-ray and ultrasound. Abdom Imaging 1995;20(4):333–8.
  • 25. Cappelletti S, Piacentino D, Sani G, Bottoni E, Fiore PA, Aromatario M, et al. Systematic review of the toxicological and radiological features of body packing. Int J Legal Med. 2016;130(3):693–709.
  • 26. Hahn IH, Hoffman RS, Nelson LS. Contrast CT scan fails to detect the last heroin packet. J Emerg Med. 2004;27(3):27983.
  • 27. Aldrighetti L, Paganelli M, Giacomelli M, Villa G, Ferla G. Conservative management of cocaine-packet ingestion: experience in Milan, the main Italian smuggling center of South American cocaine. Panminerva Med. 1996;38(2):111–6.
There are 26 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Article
Authors

Kemal Şener

Ertuğrul Altuğ This is me

Nazife Didem Hanoğlu This is me

Gökhan Eyüpoğlu This is me

Ramazan Güven This is me

Publication Date April 26, 2023
Published in Issue Year 2023 Volume: 13 Issue: 1

Cite

APA Şener, K., Altuğ, E., Hanoğlu, N. D., Eyüpoğlu, G., et al. (2023). Diagnostic Parameters for Body Packers. Kafkas Journal of Medical Sciences, 13(1), 51-56.
AMA Şener K, Altuğ E, Hanoğlu ND, Eyüpoğlu G, Güven R. Diagnostic Parameters for Body Packers. KAFKAS TIP BİL DERG. April 2023;13(1):51-56.
Chicago Şener, Kemal, Ertuğrul Altuğ, Nazife Didem Hanoğlu, Gökhan Eyüpoğlu, and Ramazan Güven. “Diagnostic Parameters for Body Packers”. Kafkas Journal of Medical Sciences 13, no. 1 (April 2023): 51-56.
EndNote Şener K, Altuğ E, Hanoğlu ND, Eyüpoğlu G, Güven R (April 1, 2023) Diagnostic Parameters for Body Packers. Kafkas Journal of Medical Sciences 13 1 51–56.
IEEE K. Şener, E. Altuğ, N. D. Hanoğlu, G. Eyüpoğlu, and R. Güven, “Diagnostic Parameters for Body Packers”, KAFKAS TIP BİL DERG, vol. 13, no. 1, pp. 51–56, 2023.
ISNAD Şener, Kemal et al. “Diagnostic Parameters for Body Packers”. Kafkas Journal of Medical Sciences 13/1 (April 2023), 51-56.
JAMA Şener K, Altuğ E, Hanoğlu ND, Eyüpoğlu G, Güven R. Diagnostic Parameters for Body Packers. KAFKAS TIP BİL DERG. 2023;13:51–56.
MLA Şener, Kemal et al. “Diagnostic Parameters for Body Packers”. Kafkas Journal of Medical Sciences, vol. 13, no. 1, 2023, pp. 51-56.
Vancouver Şener K, Altuğ E, Hanoğlu ND, Eyüpoğlu G, Güven R. Diagnostic Parameters for Body Packers. KAFKAS TIP BİL DERG. 2023;13(1):51-6.
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