Comparison of abdominal computed tomography with and without oral contrast in diagnosis of body packers and body stuffers

Shahnazi, Makhtoom; Hassanian‐Moghaddam, Hossein; Gachkar, Latif; Ahmadi, Narjes; Zamani, Nasim; Bahrami‐Motlagh, Hooman; Langroudi, Taraneh Faghihi; Shabestari, Abbas Arjmand; Alizadeh, Afshin Mohammad

doi:10.3109/15563650.2015.1054501

Cited by 23 publications

(17 citation statements)

References 21 publications

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“…Because of this we can use another more sensitive imaging modality. CT is clearly the best method for detecting foreign bodies and the use of helical CT has been widely advocated in the literature for detection, location and density characterization of various non-metallic foreign bodies (1)(2)(3)(4)(5)(6)(7)(8)(9)(10). Ultrasound (USG) has also been used for detection, but it has limited resolution, and will miss a significant number of packets (18).…”

Section: Discussionmentioning

confidence: 99%

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Canlı Kuryeler ve Görüntüleme: Olgu Sunumu

Tutar

Akdeniz

İkizceli

et al. 2020

Phoenix Medical Journal

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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. ÖZET Giriş: Canlı kurye, paketlenmiş uyuşturucuları vücudunda taşıyan uluslararası bir kaçakçı olarak tanımlanmaktadır. Görüntüleme yöntemleri bu hastaların teşhisi ve takibi açısından çok önemlidir. Olgu Sunumu: Sizlere bilgisayarlı tomografi ile teşhis koyduğumuz kokain paketleri taşıyan canlı kurye olgusunu sunmaktayız. 50 yaşında Brezilyalı erkek hasta klinik muayene ve gastrointestinal sistemde olabilecek şüpheli uyuşturucu paketlerinin tespiti amacıyla acil servisimize getirildi. İntoksikasyon bulgularının olmadığı belirlendikten sonra Bilgisayarlı Tomografi görüntülemesi gerçekleştirildi ve mideden rektuma kadar olan çok sayıda kokain paketlerine ait görüntü saptandı. Hasta servisimizde konservatif takip altında tutuldu ve sonucunda tüm paketleri defekasyon ile çıkardı. Sonuç: Canlı kuryeler, uyuşturucu paketinin yırtılmasının sonucu ölümcül olabileceğinden dolayı kendilerini büyük bir risk altına sokmaktadırlar. Bu tür hastalar için olası komplikasyonları saptamak, erken tedavi olanağı sağlamak ve gerektiğinde yutulmuş paketlere cerrahi müdahalede bulunmak amacıyla mutlaka görüntüleme yöntemlerine başvurulmalıdır. Bilgisayarlı tomografi vücut içindeki paketlerin saptanmasında hızlı ve güvenilir bir radyolojik metottur.

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Section: Discussionmentioning

confidence: 99%

“…After the absence of drug intoxication symptoms, we decided to perform a non-contrast abdominal CT scan. CT findings showed the presence of more than thirty rounded foreign bodies striking from stomach to rectum (figure [1][2][3][4]. At the fallowing the patient admitted that he has swallowed packages of cocaine.…”

Section: Case Reportmentioning

confidence: 99%

Canlı Kuryeler ve Görüntüleme: Olgu Sunumu

Tutar

Akdeniz

İkizceli

et al. 2020

Phoenix Medical Journal

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“…31 Shahnazi and colleagues evaluated body packers and stuffers but did not advocate endoscopic retrieval due to fear of rupture. 32 In general, most experts try to avoid endoscopy due to the fear of baggie rupture although recent studies have suggested this technique as a potential treatment in body stuffers if the condition is optimum and the GI specialist performing the endoscopy is highly skilled. 4 Invasive surgical approaches are only recommended when the process of passage is delayed or complicated by rupture and endoscopy has not located the baggies.…”

Section: Discussionmentioning

confidence: 99%

Complications and Hospital Stay after Endoscopic Retrieval of Drug Baggies in Body Stuffers: An Observational Prospective Study

Shabani¹,

Kefayati

Hassanian‐Moghaddam

et al. 2020

Preprint

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Background Body stuffers routinely receive conservative treatment, i.e. administration of the laxative polyethylene glycol for the passage of ingested drug baggies and observation. Endoscopic baggie removal may offer a safe alternative that could result in shorter hospitalization. We aimed to compare complications, hospital stay, and final outcome in body stuffers assigned to endoscopy versus conservative treatment. Methods This is an observational prospective study of body stuffers presenting to a clinical toxicology center in Tehran (Iran) in 2016-2019, irrespective of the drug ingested. Eligible patients had baggies in their upper gastrointestinal tract and presented without severe poisoning. Patients received either endoscopy or conservative treatment, and clinical outcomes were compared between the groups. Results A total of 69 patients were enrolled, with a median age of 29 years (range: 18–64), among whom 1 was female (2%). Eighteen and 51 patients were endoscopically and conservatively managed, respectively. Drugs most commonly ingested were heroin in endoscopy patients (8/18 cases; 44%) and methamphetamine in the conservative group (28/51 cases; 55%). Endoscopy patients had a shorter hospital stay (median 1.5 vs. 2 days, p = 0.018). In the conservative group, one patient died, and the rate of complications was significantly higher, with more patients experiencing side effects (OR= 1.4, 95% CI = 1.2, 1.7) and requiring intubation (OR = 1.3, 95% CI = 1.1, 1.5). Conclusion Endoscopic retrieval was associated with fewer complications and shorter hospitalization. Endoscopy may be a safe treatment for body stuffers without severe toxicity on presentation.

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“…Eng et al (31) reported a false negative finding of non-contrast CT in a verified case of cocaine body stuffing. A study on 24 body stuffers showed that although noncontrast CT was not as sensitive as that in body packers, it was still a better choice in detecting small bags compared to contrast CT (50). Another study by the same authors (51, 52) advocates low-dose CT as a screening method for body stuffers if the packages are bigger than one centimetre in size.…”

Section: Imagingmentioning

confidence: 99%

Management recommendations for body stuffers at emergency units

Hassanian‐Moghaddam

Amraei

Zamani

2019

Archives of Industrial Hygiene and Toxicology

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Managing body packers and stuffers is a challenge to emergency physicians, stuffers in particular, as there is no systematic approach to their treatment. The aim of this study was therefore to review all available literature on body stuffing and propose a guide to manage these patients. We searched Medline/PubMed, Google Scholar, and Scopus for published work on body stuffers using key words “body stuffer”, “body stuffing”, “poisoning”, “toxicity”, and “treatment” without a time limit and retrieved 290 articles, of which 61 remained after exclusion of those on “body packers” and repetitive documents. This review article evaluates and summarises the information gathered from them. The main step in body stuffer management is observation to make sure that they have passed all the swallowed packages of drugs of abuse. In some cases, imaging can be quite useful. Diagnostic pitfalls may be avoided with abdominopelvic CT without contrast, which is probably the best diagnostic method to determine the presence and the number of packages in these patients. Treatment should be specific for each group of drugs, whether it is opioids, cocaine, or amphetamine. Surgical interventions are indicated for obstruction of the intestines or package rupture. Legal precautions should be taken because of the legal complexity of body stuffing cases.

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Comparison of abdominal computed tomography with and without oral contrast in diagnosis of body packers and body stuffers

Abstract: There is a remarkable gap between detection of existence and number of packets/baggies reported by the radiologists and the real condition of the patients. A close teamwork between radiologists and toxicologists is needed to manage these problematic cases.

Cited by 23 publications

References 21 publications

Canlı Kuryeler ve Görüntüleme: Olgu Sunumu

Canlı Kuryeler ve Görüntüleme: Olgu Sunumu

Complications and Hospital Stay after Endoscopic Retrieval of Drug Baggies in Body Stuffers: An Observational Prospective Study

Management recommendations for body stuffers at emergency units

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