Öz
Introduction: The body-packer is an international smuggler who ingests packed illicit drugs. Imaging is very important for diagnosis and management of these patients.
Case report: We present a case of cocaine body-packing detected through scan. A 50-year-old Brazilian male was brought to the emergency department for detailed clinical examination and to verify any possible illicit drug packages within the gastrointestinal system. After the absence of drug intoxication symptoms, we performed abdominal computed tomography scan. And it showed the presence of ingested packets from stomach to rectum. The patient was kept under surveillance and during his observation in hospital he excreted all cocaine packets.
Conclusion: Body packers put themselves at considerable risk as rupture of packet inside the body may be fatal. The patients should be monitored to detect complications, enabling early treatment, and to remove or assist in the expulsion of drug packages from the body. Computed tomography is a fast, reliable and reproducible method for detection of ingested packets.
Anahtar Kelimeler
Kaynakça
- 1. Shahnazi M, Hassanian-Moghaddam H, Gachkar L, et al. Comparison of abdominal computed tomography with and without oral contrast in diagnosis of body packers and body stuffers, Clinical Toxicology. 2015;53(7):596-603. DOI: 10.3109/15563650.2015.1054501.
- 2. Pinto A, Reginelli A, Pinto F, Sica G, Scaglione M, Berger FH, et al. Radiological and practical aspects of body packing. Br J Radiol 2014;87: 20130500.
- 3. Glovinski PV, Lauritsen ML, Bay-Nielsen M, et al. Asymptomatic body packers should be treated conservatively. Dan Med J 2013;60(11):1-3.
- 4. Schulz B, Grossbach A, Gruber-Rouh T, et al. Body packers on your examination table: How helpful are plain x-ray images? A definitive low-dose CT protocol as a diagnosis tool for body packers. Clinical Radiology. 2014;69:e525-e530.
- 5. Bulstrode N, Banks F, Shrotria S. The outcome of drug smuggling by 'body-packers' - the British experience. Ann R Coll Surg Engl 2002; 84:358.
- 6. Mandava N, Chang RS, Wang JH. Establishment of a definitive protocol for the diagnosis and management of body packers (drug mules). Emerg Med J 2011;28:98e101. doi:10.1136/emj.2008.059717.
- 7. Wong GCK, Lai KK, Chung CH. Management of body packers in the emergency department. Hong Kong J. Emerg. Med. 2005;12(2):112-118.
- 8. De Bakker JK, Nanayakkara PWB, Geeraedts Jr LMG, et all. Body packers: a plea for conservative treatment. Langenbecks Arch Surg. 2012;397:125-130.
- 9. Glass J and Scott H. Surgical Mules: The smuggling of drugs in the gastrointestinal tract. J. R. Soc. Med. 1995; 88:450-453.
- 10. Bogusz, M J et al. Internally concealed cocaine: Analytical and diagnostic aspects. J. Forensic Sci. 1995; 40:811-815.
- 11. McCarron MM, Wood JD. The cocaine 'body packer' syndrome: diagnosis and treatment. JAMA 1983; 250:1417-20.
- 12. Ab Hamid S, Abd Rashid SN, Saini SM. Characteristic imaging features of body packers: a pictorial essay. Jpn J Radiol. 2012;30:386-392. DOI 10.1007/s11604-012-0069-4.
- 13. Karhunen, P et al. Pitfalls in the diagnosis of drugs smugglers abdomen. J. Forensic Sci. 1991; 36:397-402.
- 14. Rousset P, Chaillot PF, Audureau E, et al. Detection of residual packets in cocaine body packers: low accuracy of abdominal radiography—a prospective study. Eur Radiol (2013) 23:2146–2155. DOI 10.1007/s00330-013-2798-x.
- 15. Flach PM, Ross SG, Ampanozi G, et all. “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. European Journal of Radiology. 2012;81:2518-2526.
- 16. Schmidt S, et al. Detection of ingested cocaine-filled packets diagnostic value of unenhanced CT. Eur J Radiol. 2008; 67(1):133-8.
- 17. K. Lee, Koehn M, Rastegar RF, et al. Body Packers: The Ins and Outs of Imaging. Canadian Association of Radiologists Journal. 2012(63):318-322.
- 18. Pidoto RR, et al. A new method of packaging cocaine for international traffic and implications for the management of cocaine body packers. J Emerg Med. 2002; 23:149–153.
- 19. Ziegelera E, Grimma JM, Wirtha S, et al. Computed tomography scout views vs. conventional radiography in body-packers – Delineation of body-packs and radiation dose in a porcine model. European Journal of Radiology 2012; 81:3883-3889.
- 20. Hergan K, Kofler K, Oser W. Drug smuggling by body packing: what radiologists should know about it. Eur Radiol, 2004; 14: 736–742.
- 21. Sohail S. CT scan of body packers: findings and costs J Pak Med Assoc. 2007; 57: 400–403.
- 22. Beckley I, Ansari NAA, Khwaja HA, et al. Clinical management of cocaine body packers: the Hillingdon experience. J Can Chir. 2009;52(5):417-421.
- 23. Wackerle B. et al. Detection of narcotic-containing packages in "body-packers" using imaging procedures. Studies in vitro and in vivo. Rofo. 1986;145:274–277.
Öz
Introduction: The body-packer is an international smuggler who ingests packed illicit drugs. Imaging is very important for diagnosis and management of these patients.
Case report: We present a case of cocaine body-packing detected through scan. A 50-year-old Brazilian male was brought to the emergency department for detailed clinical examination and to verify any possible illicit drug packages within the gastrointestinal system. After the absence of drug intoxication symptoms, we performed abdominal computed tomography scan. And it showed the presence of ingested packets from stomach to rectum. The patient was kept under surveillance and during his observation in hospital he excreted all cocaine packets.
Conclusion: Body packers put themselves at considerable risk as rupture of packet inside the body may be fatal. The patients should be monitored to detect complications, enabling early treatment, and to remove or assist in the expulsion of drug packages from the body. Computed tomography is a fast, reliable and reproducible method for detection of ingested packets.
Anahtar Kelimeler
Kaynakça
- 1. Shahnazi M, Hassanian-Moghaddam H, Gachkar L, et al. Comparison of abdominal computed tomography with and without oral contrast in diagnosis of body packers and body stuffers, Clinical Toxicology. 2015;53(7):596-603. DOI: 10.3109/15563650.2015.1054501.
- 2. Pinto A, Reginelli A, Pinto F, Sica G, Scaglione M, Berger FH, et al. Radiological and practical aspects of body packing. Br J Radiol 2014;87: 20130500.
- 3. Glovinski PV, Lauritsen ML, Bay-Nielsen M, et al. Asymptomatic body packers should be treated conservatively. Dan Med J 2013;60(11):1-3.
- 4. Schulz B, Grossbach A, Gruber-Rouh T, et al. Body packers on your examination table: How helpful are plain x-ray images? A definitive low-dose CT protocol as a diagnosis tool for body packers. Clinical Radiology. 2014;69:e525-e530.
- 5. Bulstrode N, Banks F, Shrotria S. The outcome of drug smuggling by 'body-packers' - the British experience. Ann R Coll Surg Engl 2002; 84:358.
- 6. Mandava N, Chang RS, Wang JH. Establishment of a definitive protocol for the diagnosis and management of body packers (drug mules). Emerg Med J 2011;28:98e101. doi:10.1136/emj.2008.059717.
- 7. Wong GCK, Lai KK, Chung CH. Management of body packers in the emergency department. Hong Kong J. Emerg. Med. 2005;12(2):112-118.
- 8. De Bakker JK, Nanayakkara PWB, Geeraedts Jr LMG, et all. Body packers: a plea for conservative treatment. Langenbecks Arch Surg. 2012;397:125-130.
- 9. Glass J and Scott H. Surgical Mules: The smuggling of drugs in the gastrointestinal tract. J. R. Soc. Med. 1995; 88:450-453.
- 10. Bogusz, M J et al. Internally concealed cocaine: Analytical and diagnostic aspects. J. Forensic Sci. 1995; 40:811-815.
- 11. McCarron MM, Wood JD. The cocaine 'body packer' syndrome: diagnosis and treatment. JAMA 1983; 250:1417-20.
- 12. Ab Hamid S, Abd Rashid SN, Saini SM. Characteristic imaging features of body packers: a pictorial essay. Jpn J Radiol. 2012;30:386-392. DOI 10.1007/s11604-012-0069-4.
- 13. Karhunen, P et al. Pitfalls in the diagnosis of drugs smugglers abdomen. J. Forensic Sci. 1991; 36:397-402.
- 14. Rousset P, Chaillot PF, Audureau E, et al. Detection of residual packets in cocaine body packers: low accuracy of abdominal radiography—a prospective study. Eur Radiol (2013) 23:2146–2155. DOI 10.1007/s00330-013-2798-x.
- 15. Flach PM, Ross SG, Ampanozi G, et all. “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. European Journal of Radiology. 2012;81:2518-2526.
- 16. Schmidt S, et al. Detection of ingested cocaine-filled packets diagnostic value of unenhanced CT. Eur J Radiol. 2008; 67(1):133-8.
- 17. K. Lee, Koehn M, Rastegar RF, et al. Body Packers: The Ins and Outs of Imaging. Canadian Association of Radiologists Journal. 2012(63):318-322.
- 18. Pidoto RR, et al. A new method of packaging cocaine for international traffic and implications for the management of cocaine body packers. J Emerg Med. 2002; 23:149–153.
- 19. Ziegelera E, Grimma JM, Wirtha S, et al. Computed tomography scout views vs. conventional radiography in body-packers – Delineation of body-packs and radiation dose in a porcine model. European Journal of Radiology 2012; 81:3883-3889.
- 20. Hergan K, Kofler K, Oser W. Drug smuggling by body packing: what radiologists should know about it. Eur Radiol, 2004; 14: 736–742.
- 21. Sohail S. CT scan of body packers: findings and costs J Pak Med Assoc. 2007; 57: 400–403.
- 22. Beckley I, Ansari NAA, Khwaja HA, et al. Clinical management of cocaine body packers: the Hillingdon experience. J Can Chir. 2009;52(5):417-421.
- 23. Wackerle B. et al. Detection of narcotic-containing packages in "body-packers" using imaging procedures. Studies in vitro and in vivo. Rofo. 1986;145:274–277.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Radyoloji ve Organ Görüntüleme |
| Bölüm | Olgu Sunumları |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Mart 2020 |
| Gönderilme Tarihi | 18 Aralık 2019 |
| Kabul Tarihi | 21 Ocak 2020 |
| Yayımlandığı Sayı | Yıl 2020 Cilt: 2 Sayı: 1 |
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