CURIOUS CASE OF BODYPACKERS :
A male aged 40 travelling back to his country developes a sudden seizure on flight. The examination and CT reveal
confirm him to have ingested amphetamine packets for smuggling.
Body packing refers to the internal concealment of drugs within the gastrointestinal tract or other orifices. People who do this may be called body packers, (drug) mules, stuffers,couriers or swallowers. Drugs may be concealed within condoms, foil, latex or cellophane.
Patients suspected should be admitted for
observation. A careful history taken in private is important , but the patient may with hold the details of the drug involved for obvious reasons.
The mouth ,rectum, and vagina should be examined as possible sites for concealed drugs. Packages may be visible as plan abdominal films but this is not always the case and ultrasound and CT provides more sensitive methods of visualization.
Plain radiography reveal smooth, well-circumscribed foreign bodies measuring approximately 2-3 cm (although may be variable in size and shape) with or without surrounding air-rim or halo from air within the packets (the 'double-condom sign') .
'Rosette-sign' of air trapped within the tied-off end
CT may reveal smooth, well-circumscribed foreign bodies measuring approximately 2-3 cm (although may be variable in size and shape).
RISKS AND INTERVENTION:
Antimotility agents are often used by bodypackers to prevent premature passage of the packages ,so it can take a number of days for packages to pass and during this period the carrier is at a risk from package rupture.
Whole bowel irrigation is commonly used to accelerate the passage and is continued til packages have passed. Surgery may be required for mechanical bowel obstruction or when clinical features suggest package rupture.