Abstract
Experience with management of drug-packers (mules) is variable among different centres. However, despite a recorded increase in drug trafficking in general, as yet, no unified, clear guidelines exist to guide the medical management of those who only occasionally encounter these individuals. We describe our recent experience with this growing problem and discuss the most salient points concerning the contemporary management of body packers. Our recent experience demonstrates that type IV packages may now be managed conservatively for the most part.
Highlights
Experience with management of drug-packers ("mules") is variable among different centres
Acute drug intoxication due to rupture of the package(s) within the gastrointestinal tract leads to inadvertent over-dosage as the packages contain concentrated cocaine and can be fatal
While it is clear that small bowel obstruction is an obvious indication for surgical removal, the indications for premptive surgery to obviate the risk of rupture have changed in
Summary
Experience with management of drug-packers ("mules") is variable among different centres. Order to reveal the contents (see Figure 2) – these represent "Type IV packages" (see Table 1) [1] He underwent monitoring with serial plain radiology in order to ensure complete transit of the capsules (34 in total). This took 96 hours during which time he remained entirely asymptomatic. On presentation the patient was asymptomatic, had normal vital signs and physical examination was unremarkable. His electrocardiogram was normal and blood testing including full blood count, renal indices and liver blood tests were all within normal limits. Once passed per rectum the capsules were seen be encased in a dark, hard covering which required some considerable force to be opened in
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