Two crack cocaine body stuffers

Imaging of body packing: errors and medico-legal issues

“…Pregnant women are more prone to cocaine toxicity due to low levels of cocaine-degrading plasma esterase enzyme during gestation, and high levels of progesterone slow the metabolism of cocaine [39]. Surgery is indicated in case of gastrointestinal obstruction, perforation, cocaine toxicity, or retention of drug packets beyond 5 days despite conservative treatment [28,37,40,41]. There is no consensus on the devise of surgery in asymptomatic patients who cannot spontaneously pass drug packets.…”

“…Depending on the pureness of the narcotic, three particular patterns of attenuation have been illustrated: hashish is heavier than stool; cocaine appears comparable to stool; and heroin has an airy transparence. The packets are usually spherical or oval of a special conformity and rarely confused with scybala if arranged like a pearl chain [41,42]. While the diagnostic board of body packers has often been illustrated in literature [43][44][45][46][47], the optimal imaging approach of body stuffers is failing delineated and remains dubious.…”

The fatal case of a cocaine body-stuffer and a literature review – towards evidence based management

“…Although it was once held that orally ingested cocaine would cause little systemic toxicity because gastric acid would almost entirely hydrolyse the drug to it is inactive metabolite, benzoylecgonine, it is now appreciated that the entire spectrum of cocaine intoxication and threats to life can occur after oral ingestion. 7 The primary toxic effects of cocaine are on the cardiovascular and central nervous systems and the doctor should look for the typical constellation of signs that include tachycardia, hypertension, mydriasis and agitation. Patients with cocaine intoxication may complain of a multitude of symptoms including altered mental state, chest pain, syncope, palpitations, seizures, dyspnoea and abdominal pain.…”

“…One report discusses two young men who presented to an emergency department after ingesting packets containing crack cocaine. 7 The first male developed headache, tachycardia and raised creatinine phosphokinase (CPK) 24 h after ingestion, whereas the other had the first of three cocaine-related seizures 10 h after ingestion. In a retrospective case series of patients attending another emergency department, 98 individuals were identified who either admitted to or were strongly suspected of ingesting crack cocaine as a means of escaping detention by authorities.…”

Contrast CT scan fails to detect the last heroin packet

“…As performed in this case, most authors recommend activated charcoal and WBI as the initial decontamination procedure. However, this is an imperfect method and packets occasionally remain even after a clear rectal effluent (4,9). Thus, ensuring that decontamination is complete becomes a critical step before release of a body packer.…”