Body-Packer &amp; Body-Stuffer – eine medizinische Herausforderung

Gsell, Matthias A. F.; Perrig, Martin; Eichelberger, Melissa; Chatterjee, Biswadip; Stoll, U; Stanga, Zeno

doi:10.1024/1661-8157/a000103

Cited by 9 publications

(8 citation statements)

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“…After a history and physical examination, an x-ray overview screening of the abdomen is performed (37). Gsell et al described how all body packers were admitted to hospital and then accommodated in special rooms (37). In some cases the diagnosis can be obtained only via CT scanning (37).…”

Section: Body Packingmentioning

confidence: 99%

Swallowed Foreign Bodies in Adults

Ambe

Weber²,

Schauer³

et al. 2012

Deutsches Ärzteblatt International

207

215

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Section: Body Packingmentioning

confidence: 99%

Swallowed Foreign Bodies in Adults

Ambe

Weber²,

Schauer³

et al. 2012

Deutsches Ärzteblatt International

207

215

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“…In case of cocaine-containing packets, rupture is life-threatening and immediate surgical evacuation of the drug containers is the recommended treatment [8]. Additionally – during preparation for surgery – symptomatic treatment of cocaine intoxication should be started including benzodiazepines for agitation or seizures, calcium channel blockers or nitrates for hypertension, sodium bicarbonate to prevent ventricular arrhythmia in case of a broad QRS complex, and physical cooling for hyperthermia [1, 9]. …”

Section: Introductionmentioning

confidence: 99%

A patient full of surprises: a body packer with cocaine intoxication, pneumococcal pneumonia and HIV infection

2018

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BackgroundSmuggling of illegal drugs by hiding them inside one’s own body, also called body packing, is a worldwide phenomenon. Cocaine is the most frequently transported drug. Body packing is a potentially lethal practice. The most serious complications of body packing are gastrointestinal obstruction or perforation and drug toxicity due to packet leakage or rupture.Case presentationA 30-year-old confirmed body packer was brought to our emergency department from jail because of agitation and mydriasis. He presented with a high respiratory rate of 40/min but normal oxygen saturation on ambient air, a heart rate of 116 bpm, a blood pressure of 116/68 mmHg and a temperature of 38.0° Celsius. Blood tests were suggestive of infection, urine analysis was positive for cocaine. Abdominal and thoracic computed tomography scans showed pulmonary infiltrates as a possible focus of infection; signs of bowel obstruction or perforation were absent. Given his clinical presentation, we suspected severe infection rather than massive cocaine intoxication to be the main problem. We therefore withheld immediate surgical decontamination. Instead, we started broad-spectrum antibiotic treatment with piperacillin/tazobactam plus clarithromycin for suspected severe community-acquired pneumonia or abdominal sepsis and treated the patient with intravenous midazolam for symptomatic cocaine intoxication. After detection of urinary pneumococcal antigen, the antibacterial regimen was changed to ceftriaxone and vancomycin for pneumococcal pneumonia. In addition, we found human immunodeficiency virus (HIV) type 1 infection as underlying disease. The patient recovered from his acute illness and was discharged after 7 days of treatment with ceftriaxone plus vancomycin. Antiretroviral therapy was started in an outpatient setting.ConclusionsWith this case report, we emphasize the need to look for alternative diagnoses to intoxication and gastrointestinal obstruction in acutely ill body packers with atypical presentation. Special risks, such as underlying HIV infection and potential antimicrobial resistance according to the individual’s geographical origin, should be taken into account while treating these patients.

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“…As body packers often smuggle their packets by stuffing them into the rectum, it is absolutely essential to obtain information regarding the whole gastrointestinal tract. 10 Hospitals in Denmark routinely take at least three x-ray images of every patient suspected of body packing. 11 Overall, the present results, which concur with several other reports, 4,8,12e14 demonstrate that CT provides several advantages over abdominal radiography with respect to the visibility of intracorporeal foreign bodies.…”

Section: Discussionmentioning

confidence: 99%