![]() ![]() 6 CT scan is more sensitive than abdominal x-ray to determine a body packer since it identifies the different types of drugs on the basis of differences in the Hounsfield units with heroin having a value of i520 and cocaine with i219. One or more of these signs confirm the diagnosis of a body packer by abdominal radiograph. The drug packets may appear on a plain abdominal radiograph as multiple, radiopaque similar sized shadows packets arranged in parallel with the bowel lumen known as "parallelism"- thin rim of air trapped between the wrapping layers, the "double condom sign"- multiple cylindrical shaped packets throughout the stomach and bowel, the "tictac sign" and air trapped at the tapered end of the packets, the "rosette sign". 5Ī plain abdominal radiograph is one of the most widely available, cost effective and non-invasive methods for screening body packers with a sensitivity of almost 85 to 90%. states a heroin body packer with signs of overdose managed successfully with progressively increasing doses of naloxone. ![]() Our case did not have any signs of heroin toxicity, but a case report by Vahabzadeh, et al. 2 Immediate measures need to be taken to combat these side effects. ![]() Altered mental staus, miosis, decreased bowel sounds followed by respiratory depression are some of the important signs of heroin toxicity. A thorough physical examination should include the vitals, mental status of the patient, bowel sounds and pupil size in view of any toxic effects induced by the drug. Information regarding the number of packets ingested or inserted in any orifices and the type of the drug should be inquired though in most of the cases honest confession by the detainee is rare. 4Ī detailed history regarding the symptoms, namely pain abdomen, distension, nausea vomiting, constipation should be taken. reports a case of a female body packer who died due to the effect of ruptured heroin packets concealed in her gastrointestinal tract. 3 Loosely packed drugs are highly prone to rupture and lead to life threatening consequences progressing to death. The size and weight of the packets depend upon the type of the illicit drug, the size of the body packer and the materials and skills of packaging. Heroin, cocaine and cannabis are the most commonly used drugs, earlier with precarious packaging to sophisticated automated ones these days which use waterproof multilayered latex sheath of balloons or condoms. The emergence of body packers date back to the early seventies where predominantly young men were used for this purpose, however, there are evidences of adolescent males and pregnant women being used for the same. His abdominal radiograph revealed striking features of multiple well circumscribed similar sized elongated radiopaque shadows with a thin peripheral rim of lucency ( Figure 1).īody packing is one of the common means of transporting illegal drugs across high security ports worldwide by drug traffickers since many decades. A grossly intact neurology with reactive pupils bilaterally and unremarkable findings in the respiratory and cardiovascular systems were evident. A distended but soft and non-tender abdomen was revealed during his gastrointestinal examination. His vitals showed an increase in blood pressure of 170/100mm Hg, a tachycardic pulse rate of 114 beats per minute, respiratory rate 20 breaths per minute, temperature 98 degrees Fahrenheit and an oxygen saturation of 95% in room air. He was well oriented to time place and person but became increasingly anxious during the examination and started sweating excessively. The patient reluctantly consented for a general physical examination. He was under medication for hypertension since the past 10 years. There was no vomiting, chest pain, cough, shortness of breath or seizures. On arrival in the ED, he denied history of ingestion of any illicit drugs, however complained of nausea and abdominal fullness. This was further confirmed by the suspicious behavior of the person in the form of restlessness, not eating or drinking anything or going to the toilet and furthermore, holding his abdomen throughout the flight. He was detained in the airport following some relevant piece of information regarding his destination. A 49-year-old male was brought to the Emergency Department (ED) by the airport police officials with a high suspicion of carrying illegal drugs.
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