A Five-year Report on Body Packing and Body Stuffing in Isfahan

Background: Body packing and body stuffing of illicit drugs have increased in recent decades. The drug contents of the packages vary from region to region, and there are controversies surrounding the diagnostic and therapeutic methods. The aim of this study was to explore the clinical presentations, diagnostic and therapeutic measures, and the subsequent clinical outcomes of drug concealment by people. Methods: A retrospective analysis was performed on data for all cases of body packing and body stuffing that were referred to a university hospital, in Isfahan, Iran, from Mar. 2013 to Feb. 2018. Results: Sixty-eight body stuffers and 18 body packers (n=86) were included in this study. Seventy-eight patients (90.7%) were male, mostly aged between 20 to 40 years. There was no significant difference between the two groups with respect to the signs and symptom, hospital stay, treatment and clinical outcomes. Heroin and crystal methamphetamine, n=52 (60%) and n=22 (25%), respectively, were the most substances detected, irrespective of the concealment method. Abdominal X-ray and CT scan tests were positive for the detection of at least one packet in each of the 94.4% of the patients. Conclusion: Heroin and crystal methamphetamine were the most common substances concealed in the bodies of the patients. Based on our findings, CT scan was more sensitive than abdominal X-ray test in the detection of illicit drug packets concealed in the patients. Close observation and whole bowel irrigation were effective therapeutic modalities in most cases. All cases were fully recovered and discharged from the hospital.

Body packing: tráfico de drogas y cirugía. Reporte de un caso.

Objetivo: Exponer el caso de un paciente con intoxicación aguda por cocaína en contexto de un “Body Packer Syndrome”, considerando sus aspectos médico-quirúrgicos y legales.Materiales y Método: Se obtuvo la ficha clínica, con resguardo de anonimato, de un paciente que acude al Servicio de Urgencia (SU) y que es intervenido y evolucionado posteriormente en el Hospital el Pino de San Bernardo, Chile.Resultados: Paciente fue sometido a una gastrotomía, una enterotomía y una colotomía después de haber sido estabilizado por paro cardiorrespiratorio presentado en SU. Es trasladado a Unidad de Cuidados Intensivos (UCI) donde evoluciona desfavorablemente.Discusión: El “Body Packer Syndrome” es una entidad clínica infrecuente que, en la minoría de los casos, puede presentar complicaciones severas que requieren de un tratamiento médico-quirúrgico inmediato.Conclusión: Considerando que tanto el consumo como el tráfico de drogas se mantienen como un importante problema de salud pública y que sus consecuencias pueden ser devastadoras, es importante tener conocimiento sobre el tema.

Suspicious Case of a Body packer “Mule” in a Low Resource Country: A Case Report

Body packing is the process of smuggling illicit drugs in the form of packages concealed within the gastrointestinal tract via ingestion or inserting into body orifices. These individuals are described as “body packers”, “stuffers”, “mules” or “swallowers” and resort to carrying drugs like heroin, cocaine and cannabis. They present to the hospital following the development of complications or brought dead due to the rupture of packets or directly from detention for further investigations. This case illustrates a suspected case detained from the airport who was found to be carrying 93 pellets of an illicit drug, heroin, weighing 900 grams, one of the highest quantity carried by any body packer in the country till date. This case further sheds light on the fact that a meticulous history, detailed clinical examination and radiographic investigations like abdominal radiograph and imaging are the keys to diagnose body packers in a resource limited setting.

Clinical, Diagnostic, and Treatment Features of Body Packing in Brazil: Drugs, Cell Phones and Beyond

Introduction: Body packing is the smuggling of drugs and other contents inside the human body. However, non-narcotic contents studies are limited to rare case reports in literature. Thus, the objective of this study was to investigate cases of body packers in Brazil considering narcotic and non-narcotic contents. Methods: Retrospective study analyzing the medical records of body packers admitted from January 2015 to December 2019 at one of the main tertiary hospitals in central Brazil. Results: Ten cases of body packing were observed. Only 50% of the patients carried drugs, while surprisingly, 70% carried non-content, especially cell phones and accessories. All the patients were male, prisoners and young adults. In 60%, there were gastrointestinal obstruction and in 30%, there was acute narcotic intoxication. Abdominal radiography was enough for diagnosis in 80% of the cases. In 90% of the cases, emergency laparotomy was required, but all the patients successfully recovered. Conclusions: There was a higher prevalence of body packing of non-narcotic content; however, clinical and radiological presentations were similar to those of narcotic content. Emergency surgery proved to be effective for both content types. This study highlights the concerning high prevalence of body packing of cell phones and accessories in addition to drugs.

Case Report: Don’t chew the fufu: a case report of suspected drug body stuffing

Background: Intrabody concealment of illicit substances is a common practice in the trafficking chain. Body packing is a technique used in drug trafficking that consists of deliberately ingesting many drug pellets. Body stuffing consists of precipitously swallowing packets of substances, which are smaller and more fragile than body-packing pellets, for concealment from law-enforcement officers in anticipation of impending search or arrest. Therefore, body stuffing is particularly dangerous due to the rupture risk of the loosely wrapped drug packets, which could lead to substance intoxication or even death. Case presentation: This article reports the case of a young man who was taken by law enforcement authorities to our Emergency Department for investigation of suspected body stuffing. Although the patient denied the facts, the initial reading of the computed tomography (CT) scan confirmed the presence of multiple images compatible with drug pellets, which were mostly in the stomach. The pellet findings were more consistent with body packing than body stuffing as initially suspected by the police. However, upon admission to our secured inpatient ward for clinical surveillance of pellet evacuation, the patient denied again having ingested such pellets, and declared that he only ate ‘fufu’. Fufu is a traditional food of central and western Africa consisting of a starchy preparation compacted by hand into small balls. Fufu balls are usually swallowed without chewing to allow a sensation of stomach fullness throughout the day. Considering the fufu intake history, a careful reassessment of the imaging confirmed the presence of food content. Conclusions: This case study offers an example of suspected intrabody concealment of illicit substances, which turned out to be false positive due to fufu. It illustrates the importance of a history of food intake that could bias the interpretation of CT scan images.