Prognosis of cocaine body-packers

Prost, Nicolas de; Lefebvre, A.; Questel, Frank; Roche, N.; Pourriat, Jean-Louis; Huchon, G.; Rabbat, Antoine

doi:10.1007/s00134-005-2660-y

Cited by 54 publications

(49 citation statements)

References 21 publications

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“…McCarron and Wood7 identified three types of drug packets (see table 1). de Prost et al ,6 in a series of 581 body packers, found that type 1 packets were rare (prevalence 9%), but were strongly associated with complications, being present in five of the eight patients (prevalence 62.5%) who required admission to the intensive therapy unit for complications including poisoning and obstruction. A drug history may reveal drug dependence or co-ingestion of constipating agents to prevent premature passage of the deadly cargo.…”

Section: Resultsmentioning

confidence: 99%

“…Although there were no randomised trials, 10 case series were identified 1 4 – 12. Only two case series reported on more than 100 cases; 581 cocaine body packers in France6 and 572 suspected body packers in England 1. Numerous other single and double case reports were found in both the biomedical and forensic science literature.…”

Section: Resultsmentioning

confidence: 99%

“…de Prost et al 6 found that 91 of 175 cocaine body packers tested positive for cocaine on urine testing (sensitivity of 52%). Furthermore, a positive test may arise from contaminated outer packets, semipermeable wrappings, or from recreational use.…”

Section: Resultsmentioning

confidence: 99%

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Packers, pushers and stuffers--managing patients with concealed drugs in UK emergency departments: a clinical and medicolegal review

Booker¹,

Smith

Rodger

2009

Emergency Medicine Journal

104

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Body packing, pushing and stuffing are methods by which illicit drugs may be carried within the human body. Patients involved in these practices may present UK emergency departments with complex medical, legal and ethical considerations. This review article examines not only the evidence behind the clinical management of these patients, but also the legal powers afforded to the authorities to authorise the use of intimate searches and diagnostic imaging for forensic purposes. Serious complications from concealed drug packets are now rare, and most asymptomatic patients may be safely discharged from hospital after assessment. Emergency surgery is indicated for body packers with cocaine poisoning and for some cases of heroin poisoning. Urgent surgery is indicated for obstruction, perforation, the passage of packet fragments and failure of conservative treatment. Guidance is given for doctors who are faced with requests from the authorities to perform intimate searches and diagnostic imaging for forensic purposes.Concealment of illicit drugs may occur in a number of settings. Body packers swallow drugs in rubber or latex packets in an attempt to transport them across international borders without detection. 1Body pushers insert drug packets into the rectum or vagina. The number and size of the packets may vary, but each one will usually contain many times the toxic dose of the drug, most commonly either cocaine or heroin. The sophistication of the packaging methods used by drug smuggling organisations results in a low morbidity to their ''drug mules'', although packet failure may still cause poisoning in the country of origin, 2 during flight, 3 or at their destination. 4 Body stuffers spontaneously swallow either unwrapped or poorly wrapped drugs when fearing apprehension by the authorities, in order to dispose of evidence and frustrate the legal process.5 They are distinct from pushers and packers in the amount of drug and integrity of packaging used.The Drugs Act 2005 gives additional powers to the police services of England and Wales to authorise imaging of suspected body packers. The aim of this article is to provide an evidence-based approach for the emergency department (ED) management of suspected body packers, pushers and stuffers, and to summarise the law relating to forensic imaging. METHODSA comprehensive literature search was carried out using the Datastar interface. Search terms included ''body packing'', ''foreign bodies'', ''stomach'', ''heroin'', ''cocaine'' and ''drug''. The databases interrogated were Medline (1950 to December 2006), CINAHL (1982 to January 2007 and EMBASE (1974( to January 2007. Papers were included if they contained original data regarding body packing. The bibliographies of relevant papers were examined and cross-referenced. Papers were critically appraised for the quality of evidence presented. The criteria used were relevance to the question asked and study design. Studies were preferred in accordance with the usual hierarchy of evidence, namely controlled clinical...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Packers, pushers and stuffers--managing patients with concealed drugs in UK emergency departments: a clinical and medicolegal review

Booker¹,

Smith

Rodger

2009

Emergency Medicine Journal

104

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show abstract

“…La distinción de estos dos escenarios determinará el manejo del paciente, bien sea conservador o quirúrgico 3,15 . El manejo de los que constituyen la mayoría de los "body packers", pacientes asintomáticos, actualmente se enfoca en la evacuación espontánea de los paquetes durante la monitorización y observación continua de signos vitales, previniendo las posibles complicaciones, dado por el enfoque interdisciplinario del servicio de Urgenciología, Toxicología y Cirugía general 16 . Aunque la cirugía temprana alguna vez fue recomendada en este tipo de pacientes, probablemente debido a la alta tasa de ruptura espontánea de los paquetes con envoltura primitiva 17 , con la realización de múltiples estudios sobre el manejo conservador desde los años ochenta se ha reportado una tasa de fracaso del manejo médico conservador del alrededor del 5 %, y puede ir en descenso en la medida que la producción de los paquetes mejora, como se evidenció en nuestro trabajo, con una tasa de éxito del 100 % con el uso de polietilenglicol (PEG) 4,[18][19][20][21] .…”

Section: Discussionunclassified

Tratamiento médico del “body packer” entre los años 2014 y 2016 en un hospital universitario del caribe colombiano

2018

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Citar como: Mercado MF, Ensuncho CR, Posada JC. Tratamiento médico del "body packer" entre los años 2014 y 2016 en un hospital universitario del caribe colombiano. Rev Colomb Cir. 2018;33:135-44. https://doi.org/10.30944/20117582.71 Tratamiento médico del "body packer" entre los años 2014 y 2016 en un hospital universitario del caribe colombiano ResumenIntroducción. El término "body packer" hace referencia a sujetos portadores de objetos intraabdominales extraños, que contienen drogas ilícitas con fines de contrabando. La mayoría son pacientes asintomáticos, en quienes se instaura conducta expectante, observación clínica estrecha y administración de medicamentos para la evacuación de los paquetes, con miras a prevenir posibles complicaciones, como obstrucción intestinal o intoxicación, asociadas a su transporte intraabdominal. Materiales y método. Se llevó a cabo un estudio transversal de linealidad retrospectiva en pacientes admitidos en la E.S.E Hospital Universitario del Caribe entre los años 2014 y 2016,bajo la sospecha diagnóstica de "body packer". Luego de una revisión de las bases de datos institucionales se analizaron variables demográficas y clínicas de los sujetos incluidos en el estudio. Resultados. Se incluyeron 4 pacientes de género masculino, entre los 22 y 66 años de edad. La cantidad de cápsulas transportadas en promedio fue de 43, para una máxima de 74. La cocaína fue la sustancia que más se identificó. Para la evacuación de los paquetes se empleó irrigación intestinal con polietilenglicol. El tiempo de evacuación máximo fue de 48 horas y no hubo complicaciones asociadas al manejo proporcionado. Discusión. Estudios respecto al tema, como este, confirman la seguridad del manejo conservador del paciente asintomático y apoyan el uso de polietilenglicol dada su efectividad para lograruna limpieza intestinal completa y por su bajo riesgo de complicaciones asociado a su uso en comparación con otros métodos, así como la menor necesidad de intervenciones quirúrgicas. Se requieren estudios prospectivos aleatorizados controlados a partir de los cuales se determinen, con base en mayor evidencia, las mejores prácticas a seguir. Palabras clave: transporte intracorporal de contrabando; tráfico de drogas; radiografía abdominal; glicol de etileno. AbstractIntroduction. The term "body packer" refers to subjects carrying intraabdominal foreign objects that contain illicit drugs for contraband purposes. The majority of patients are asymptomatic, in whom expectant management is established, with close clinical observation and administration of medications for evacuation of the packages, with prevention of possible complications such as intestinal obstruction or intoxication associated with intraabdominal transport.

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“…2 Immediate laparotomy is indicated in case of high suspicion of rupture. 2,3 There are relatively few in vivo data regarding the toxicokinetics of cocaine and its metabolites in body-packers who develop clinical symptoms and require surgical management. 4 We describe here a case with serial determination of plasma concentrations of cocaine and its metabolites.…”

Section: Introductionmentioning

confidence: 99%

Toxicokinetics of cocaine and metabolites in a body-packer becoming symptomatic

Hantson

Capron

Wallemacq

2011

Journal of Forensic and Legal Medicine

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Prognosis of cocaine body-packers

Abstract: Good prognosis observed in these body-packers cases is due to the careful monitoring of asymptomatic patients, allowing early detection and treatment of complications. Surgical removal of the packets when complication occurs is warranted.

Cited by 54 publications

References 21 publications

Packers, pushers and stuffers--managing patients with concealed drugs in UK emergency departments: a clinical and medicolegal review

Packers, pushers and stuffers--managing patients with concealed drugs in UK emergency departments: a clinical and medicolegal review

Tratamiento médico del “body packer” entre los años 2014 y 2016 en un hospital universitario del caribe colombiano

Toxicokinetics of cocaine and metabolites in a body-packer becoming symptomatic

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