Body Packing Research Articles

Body Packing: A Review of Imaging Modalities and Aspects

Body Packing: A Review of Imaging Modalities and Aspects

Enhancing Diagnostic Accuracy in Body Packing Cases: The Impact of Preliminary Diagnosis Awareness on Computed Tomography Evaluation

Objective: Body packing refers to the concealment of illegal substances within the body. This study aims to evaluate the computed tomography (CT) findings of body packing cases, and to assess whether considering the possibility of body packing in preliminary diagnosis will affect the accuracy of specialists evaluating in the emergency and intensive care departments. Materials and Methods: 20 body packing cases were retrospectively examined for the presence of foreign bodies. A control group was created from 20 non-contrast abdominal CT images. Re-evaluation involved four radiologists. Before evaluating, two radiologists were advised they could be body packers. Results: In 18 (90%) of 20 body packers, foreign bodies were visible in the intestinal lumen, mostly 14 (70%) in the colon. Radiologists who were given preliminary diagnosis, correctly identified all 18 (100%) intestinal foreign body cases and did not make any false positives. Two other radiologists correctly identified 16 (88.9%) cases and missed 2 (11.1%) cases and there was significantly difference (p

An unexpected computed tomography finding in a suspected body packer

Introduction Computed tomography can be used to screen and diagnose the presence of drug-filled packets in the body. We present an unusual computed tomography finding in a suspected body packer. Case summary A traveller suspected of being a body packer was brought to the emergency department complaining of low back pain. On examination, there was an abdominal cast circumferentially encasing his abdomen, which he alleged was part of the management of his lower back pain in his own country. Images A plain computed tomogram of the abdomen and pelvis revealed that the cast was made of materials with a nodular appearance and heterogeneous density, which was different from that of a plaster of Paris cast. An investigation later confirmed the cast contained cocaine. Conclusion Our case demonstrates how a body packer can traffic drugs outside their body for an alleged medical reason.

Body Packer Syndrome - Ethical Issues? A Case Series

Transporting the foreign bodies, goods, outside or inside the body is called body packer or body pusher or body stuffers and also mules. Contraband substances and specially gold are smuggled in this process. If suspected by Custom Agency or the Police, they refer the case for medical examination and further medico-legal process of recovery of these substances from human body. The role of the doctors is very crucial as far as the life of mules, amount of material to be recovered, preservation of the evidence material including documents, radiological evidence, x-rays and the procedural methods followed, till handing over the recovered material to the concerned officer and keeping records. In the present study, we discussed various cases of body packers which smuggled cocaine and gold. NCCT scan of abdomen is more effective technique to identify body packers. The work experience of such cases in tertiary care hospital is presented here with the aim to share with medical professionals and medico-legal experts.

Emergency service management of bodypacking cases caught on the highway outside the borderline

Objective: While drug trafficking is a major problem worldwide, body packing involving the storage of narcotic drugs in the human body represents an emergency because of the risk of deadly narcotic toxicity, intestinal obstruction and visceral perforation. We presented the evaluation of body packer cases, which have not been seen before in this region, in the emergency clinic. Methods: This study analyzes the medical records of body packers from January to July 2023.Hematological and biochemical tests, abdominal radiographs and tomographies, and removed packages were evaluated in all cases. Results: Nine body packer cases carrying narcotic substances were observed in this study. The mean age was 33 ± 6.3, 2 (22%) were female and 7 (78%) were male. None of the patients required emergency surgery. One patient had acute narcotic intoxication. In this patient, whose packages were observed to be intact, drug intoxication was associated with substance use. Abdominal radiography diagnosed all cases and all were recovered and discharged. Conclusion: It is very important for public safety to diagnose body packing cases and prevent the transport of packages. In this issue, emergency physicians should have radiography and CT imaging features in asymptomatic body packing cases.

A Fatal Case of Opioid Body Packer Syndrome Presented with Seizures

A Fatal Case of Opioid Body Packer Syndrome Presented with Seizures

Body Packer Syndrome: a health hazard of deglutitioned controlled drugs

A case of an accidental overdose in a body packer or drug courier is reported. It highlights a health hazard of deglutitioned controlled drugs. A clinico-pathological aspect of the body packer syndrome is discussed.

A Disturbing Diagnosis to Consider: Rectal Body Packing in Young Children.

A Disturbing Diagnosis to Consider: Rectal Body Packing in Young Children.

Drug trafficking and body packing, case series and brief review: an afternoon experience

Drug trafficking and body packing, case series and brief review: an afternoon experience

Review of the book “Radiology in Forensic Medicine. From Identification to Postmortem Imaging” translated from English under the editorship of Professor V.A. Klevno

The book Radiology in Forensic Medicine. From Identification to Postmortem Imaging, translated from English under the editorship of Professor V.A. Klevno, is reviewed.
 The review aimed to objectively evaluate the content of the scientific and practical publication and to determine its value for science and practice.
 The book consists of 29 chapters. Each chapter includes a list of references. The history of forensic radiology is briefly described, and the advantages, and disadvantages of traditional autopsy versus postmortem imaging are reviewed. This book focuses on postmortem imaging in forensic medicine and special forensic radiology, including imaging of corpses after various types of external exposure, during sudden death, of fetuses, and newborns and of putrefied and charred corpses. Several chapters are devoted to imaging in clinical forensic medicine to assess injuries, detect drug smuggling by body packers, and diagnose some occupational diseases. The role of postmortem imaging in identifying victims of mass disasters is discussed. The authors critically evaluate the advantages and limitations of virtual autopsy.
 Given the advancements of interdisciplinary approaches in forensic medicine and the increasing role of radiologists in forensic practice, the publication of this book in Russian is more relevant than ever. It will be of interest to both forensic physicians and radiologists.

The most practical diagnostic imaging for detecting body packers during the drug trafficking: Ultrasonography.

Body packing is one of the most common methods used in the transboundary trafficking of illicit drugs. These drugs are packaged in capsules and taken orally or inserted into the rectum or vagina. Its diagnosis is, therefore, difficult. Methods like x-ray, ultrasonography, and computed tomography (CT) are usually used to diagnose body packers. This study aimed to evaluate the diagnostic power and feasibility of ultrasonography as a diagnostic tool in patients who have a suspicion of being body packers. This study is designed as a prospective and single-centered case-control study in the emergency department of a training and research hospital. Cases admitted to the emergency department with suspicion of being a body packer were included in the study. The data obtained was recorded on the study form. p < 0.05 was accepted as statistically significant. One hundred and one patients were included in the study; 76.2% (n = 77) were male. Packages were detected in 56.5% (n = 57) of the cases. Ultrasonography was found to be significantly useful in evaluating the presence of intra-abdominal packages. Ultrasonography had 92.4% sensitivity and 97.8% specificity in evaluating the presence of packs. CT is frequently used to diagnose patients admitted to the emergency departments with suspected body packing. In our study, ultrasonography is an advantageous imaging method, given its success rate, radiation-free nature, and low cost. We have found ultrasonography to be a successful imaging modality in examining patients suspected of being body packers for the presence of packs, and it can replace CT in clinics.

Body packing with pyloric stenosis successfully treated with open pack retrieval and gastric bypass

Foreign body ingestion unintentionally or intentionally in adults are not uncommon on the contrary to children. Intentional ingestion of illicit drugs or tobacco/drug pack is one common reason other than psychosis. Infrequently, body packing may end up with bowel obstruction with ‘drug pack’ impacted at various constriction point of gastrointestinal tract [1]. Here, we report a case of intentional foreign body ingestion by a jail inmate whom unfortunately also has pyloric stenosis. The clinic presentations and treatment strategy are discussed.

Gastric pouch obstruction in a bariatric patient caused by the ingestion of cocaine packets: a case report

The term "Body Packing" refers to individuals who carry intra-abdominal foreign objects containing illicit drugs that have been ingested to conceal them for smuggling purposes. With the increasing rates of international smuggling, drug transportation across borders has been constantly evolving among traffickers. Once introduced into the body, it becomes a matter of significant medical concern, as it can cause bowel obstruction, perforation, peritonitis, or intoxication. We present a case of a female, 44 years old, with a history of Fobi-Capella bariatric surgery, who was admitted to an Emergency Department for intractable vomiting, excessive drooling, and confirmed ingestion of 25 cocaine packages. The abdominal CT revealed multiple foreign bodies in the gastroenteroanastomosis topography, gastric pouch, and small bowel. Exploratory laparotomy with gastrostomy, enterotomy, and colotomy was performed. A second approach with intraoperative endoscopy was conducted to remove the remaining packages that were revealed by CT. This case report provides information about body packers' clinical condition, diagnosis, and treatment, to assist surgeons and clinicians with similar cases.

Strategic Position of Riau Islands Province: A Study of Modus Operandi of Drugs Smuggling in Indonesia

The rampant case of drug smuggling in Riau Islands Province and the lack of study on its modus operandi created a gap in the current research on the topic. The objective of this study is to discover the modus operandi used, the kinds of drugs being smuggled, and the reason Riau Islands was chosen as a strategic location for the smuggling route. The data was gathered through a structured interview with the local agencies directly involved in the supervision and security against drug smuggling in Riau Islands Province. The research methodology uses interactive analysis and thematic analysis methods. The results show that the modus operandi used can be categorized as the usage of camouflage techniques such as deceptive packaging and hidden compartment; Smuggling on a person using body packing and body strapping; and conducting transactions on the high seas using large ship, speed boat, and luxury yacht while employing a ship-to-ship system, and a fishing boat. The three main drugs smuggled is Methamphetamine, Ecstasy, and Marijuana with several other in a smaller quantity. Lastly, Riau Islands Province is bordered by several countries, a major transportation route such as the Malacca Strait and the island of Sumatera. Due to the plethora of drugs smuggled and the modus operandi displayed, it is necessary for law enforcement to increase the supervision and ways to identify and counter the smuggler’s action and to secure the territory.

Study on solar-driven methanol steam reforming process in parabolic trough solar receiver-reactors by developing an optical-thermal-chemical model of realistic porosity distributions

The catalyst particle packing characteristics have a significant impact on improving the comprehensive energy conversion performance and economic benefits of sustainable solar-driven thermochemical hydrogen production systems. However, corresponding accurate and efficient numerical research tools or methods still need to be developed. In this paper, a three-dimensional comprehensive optical-thermal-chemical coupling model with catalyst particle packing characteristics is proposed for the parabolic trough solar receiver-reactor (PTSRR) of methanol steam reforming reaction (MSRR) for hydrogen production. This model is developed by combining a Monte Carlo ray tracing optical model, a computational fluid dynamics model, a MSRR comprehensive kinetic model with a Blender rigid body packing model. After validation, it was found from comparisons with previous studies that this model can represent relatively realistic catalyst porosity distributions of packed-bed reactors at a very low computational cost. Then, this model was applied to obtain the porosity of different PTSRR-MSRRs and optimize the catalyst size and shape, to achieve better comprehensive performance as well as economic benefits of higher overall efficiency and catalyst utilization efficiency. The results reveal that the PTSRR-MSRRs filled with cylinders and Raschig rings (R-PTSRR) can achieve similar high methanol conversion rate, while the R-PTSRR has more advantages with its lower average resistance coefficient and CO selectivity. After weighing the methanol conversion rate, the overall efficiency and the catalyst utilization efficiency, the optimum R-PTSRR is highly recommended. This study provides a useful option for rapid comprehensive analysis and optimization of similar solar-driven thermochemical conversion processes on catalyst particle packed beds.

Fatal cocaine body packer syndrome depicted on antemortem and postmortem CT: A case report

Fatal cocaine body packer syndrome depicted on antemortem and postmortem CT: A case report

(094) Sexual Emergencies in Women

Abstract Introduction Sexual emergencies in female patients are more common than people think. They represent medical curiosities more than pathologies for which we should be prepared to treat. This review and the presentation of our cases shows how extensive and important is this area in the medical practice and why every single physician should be prepared to confront them. Gynecologist, surgeons, sexologists, and ER physicians are familiarized with some of the sexual emergencies in women that called the attention of the medical community. However, the broad spectrum of those disorders is not well-known. Objective 1. Show the magnitude of sexual emergencies in women nationally and internationally. 2. Describe how they can vary according with the place, culture, and societies. 3. To learn the methods of diagnosis and treatment of these ample variety of conditions. Methods Based on the multiple cases seen in the ER of our facility, an extensive review of the literature was done, and the cases are presented to show the magnitude, variety, and diversity of cases in the different areas of the medical field. Results The review includes: I. The common coital emergencies in neurology (benign coital headache, subarachnoid hemorrhage, intracerebral bleeding, subdural hemorrhage, cerebral vascular accidents), urology (ureterovesical foreign bodies, obstructive uropathies), cardiology (sudden cardiac death, myocardial infarction), gynecology (vaginal lacerations and/or evisceration and death with/without previous gynecological surgeries), obstetrical (postpartum dyspareunia secondary or not to episiotomy or vaginal lacerations; postcoital preterm labor), immunological (local or systemic, anaphylactic allergic reactions). II. Common autoerotic emergencies in gastroenterology (foreign objects in rectum, vagina, oropharyngeal/mandibular lesions), as well as “body packers” cases (swallowed latex balloons for smuggling in the GI tract, rectum, or vagina). III. Sexual assault IV. Sexual dysfunction: Hyperactive arousal disorders (compulsive hunt for orgasms with/without attempt or real suicide, hypersexuality related to SSRI use). V. Sociosexual issues: Killings for jealousy during sex, infidelity, castration like Lorena Bobbitt case. Conclusions The epidemiology of these pathologies varies from country to country, and state to state, and includes women of any age, race, religion, and culture. Finally, a review of these diagnostic methods and treatment are presented. Disclosure No

(448) Sexual Emergencies

Abstract Introduction Urologist, gynecologist, surgeons, sexologists, and ER physicians are familiarized with some of the sexual emergencies that called the attention of everybody. However, the broad spectrum of those disorders is not well-known. Objective 1. Show the magnitude of sexual emergencies in an important hospital of South Florida. 2. Show the magnitude of sexual emergencies nationally and internationally. 3. Describe how they can vary according with the place, culture, and societies. 4. To learn the methods of diagnosis and treatment of these ample variety of conditions. Methods Based on the multiple cases seen in our ER in Hialeah Hospital in Miami, Florida, extensive review of the literature was done, and the cases are presented to show the magnitude, variety, and diversity of cases in the different areas of the medical field. Results The review includes: I. The common coital emergencies in neurology (benign coital headache, subarachnoid hemorrhage, intracerebral bleeding, subdural hemorrhage, cerebral vascular accidents), urology (penile fracture, priapism, preputial tears, penile vessel rupture, penile strangulation, penile necrosis, ureterovesical foreign bodies, epididymitis., obstructive uropathies), cardiology (sudden cardiac death, myocardial infarction), gynecology (vaginal laceration and/or evisceration with/without previous gynecological surgeries), obstetrical (postpartum dyspareunia secondary or not to episiotomy or vaginal lacerations; postcoital preterm labor), immunological (local or systemic, anaphylactic allergic reactions). II. Common autoerotic emergencies in gastroenterology (foreign objects in rectum, vagina, oropharyngeal/mandibular lesions), as well as “body packers” cases (swallowed latex balloons for smuggling in the GI tract, rectum, or vagina). III. Sexual assault IV. Sexual dysfunction: Hyperactive arousal disorders (compulsive hunt for orgasms with/without attempt or real suicide, hypersexuality related to SSRI use). V. Sociosexual issues: Killings for jealousy during sex, infidelity, castration like Lorena Bobbitt case. gynecologicalgynecological Conclusions The epidemiology of these pathologies varies from country to country and includes subjects of any age, sex, race, religion, and culture. Finally, a review of these diagnostic methods and treatment are presented. Disclosure No

Whole Bowel Irrigation should not be used routinely in poisoned patients.

Whole bowel irrigation is a method of gastric decontamination in the poisoned patient involving administration of large volumes of osmotically balanced polyethylene glycol-electrolyte solution to empty the gastrointestinal tract of ingested toxins before absorption, limiting systemic toxicity. While this approach may seem intuitive, and observational studies confirm it can lead to expulsion of tablets or packets in the rectal effluent, there is a lack of evidence correlating this with improved patient outcomes. Administration of whole bowel irrigation is also challenging to the inexperience physician and associated with adverse effects, which may be serious. Recommendations for the consideration of whole bowel irrigation are therefore limited to patients who have ingested modified release preparations, those of have ingested pharmaceuticals not adsorbed by activated charcoal, and for the removal of packages in body packers. Until more robust evidence is available from high-quality prospective studies demonstrating efficacy, the use of whole bowel irrigation should not be used routinely in poisoned patients.

An unusual case of small bowel obstruction because of body packing

Body packing is the internal concealment of illicit drugs for the purpose of transportation and evasion of law enforcement. It is associated with medical complications such as acute toxicity from ingested drug, bowel obstruction or perforation. It is rare to require surgical intervention with a small amount of ingested drug packet. Here, we present the case of a young adult male who presented with abdominal pain for 3days. The patient admitted ingesting a condom filled with suboxone several years ago and denied recent ingestion. The patient was found to have small bowel obstruction with ingested foreign body being a transition point on CT scan, requiring exploratory laparotomy and small bowel resection.