Abdominal CT findings of ruptured opium packets in a body packer
Introduction
“Body Packer” is the term used for smugglers who conceal and transit illicit drugs in their body cavities, usually the gastrointestinal (GI) tract [1], [2]. Different drugs such as heroin [3], cocaine (the most common reported) [4], opium [5], etc. are carried by body packers. They wrap the drugs in several layers of latex, usually condoms, balloons, and latex gloves. The number of these packets is usually between 20 and 200; each of them containing 3–15 g of the drug [2]. Body packers present in different conditions to the emergency departments (EDs) ranging from an asymptomatic one being arrested by police and transferred for medical clearance to the presence of complications of packet ingestion like obstruction and perforation of GI tract. The most important and severe of all is acute intoxication as a result of leakage or rupture of one or more swallowed packets [1], [6]. In all these situations, diagnostic imaging studies by plain abdominal X-ray [7], ultrasound [8], [9], and computed tomography (CT) scan [10], have valuable roles in the detection of hidden packets. However, detection of drug packets in an intoxicated body packer has been reported less commonly in the literature. In this report we present a case of a comatose addicted patient presented to ED with suspected opium intoxication and describe his abdominal CT findings.
Section snippets
Case report
A 42-year-old man with a known history of opium abuse, who had returned to rehabilitation center after 3 days of leave, was brought by police officers unconscious to the ED of our university hospital. He was an addicted prisoner passing his incarceration period due to narcotic-related crimes. He presented with a 6-h history of sudden and progressive abdominal pain which had started in the rehabilitation center. At presentation, he was in respiratory depression with GCS (Glasgow Coma Scale)
Discussion
Several diagnostic imaging devices such as plain abdominal X-ray, Ultrasound, CT, and MRI have been shown to have the ability to detect drug packets ingested. CT imaging is the most accurate diagnostic method among all these techniques [11]. Because of high contrast resolution (nearly 20 times more than X-ray), CT has the ability to eliminate the projections of overlapping surrounding tissues and to distinguish the packets [12], [13]. Furthermore, professional drug smugglers try to disguise
Conflict of interest
There is no conflict of interest. All authors contributed to this report significantly, and all of them agree to the contents.
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