Aims and objectives
“Drug mules” (also called “body packers“ or “swallowers“) are individuals who swallow drug in packages or sometimes introduce them into their rectum.
Plain abdominal films have been in the past the imaging technique of choice in evaluating these patients,
but computed tomography (CT) is now considered the gold standard.
Based on the experience at our radiology department,
the aim of this EPOS is to review the current role of abdominal X-ray in “drug mules” examination.
Methods and materials
In 4 years 12 suspected “drug mules” have been evaluated at our department.
The great majority of patients were male and aged between 20 and 30; all of them were brought to our hospital by the police.
Every patient underwent abdominal CT without contrast,
whereas 2 patients underwent also abdominal X-ray.
None of these patients underwent abdominal X-ray alone .
The suspected “drug mules” were found positive in 10 cases; none of them had life-threatening complications.
Abdominal X-ray was performed in two cases (both positive),
but low dose abdominal CT was necessary to understand the right number of drug packets and their exact position in the gut.
Radiological examination was repeated in 5 patients due to discrepancy between the number of packets identified at CT scan and packets retrieved in patient feces.
Even in this last case abdominal X-ray...
CT is now considered gold standard in radiological examination of “drug mules”.
Thanks to the lower radiation dose and the young age of “drug mules” abdominal X-ray could theoretically have a role in first look examination; its low sensitivity and the high risk of potentially life-threatening complications of these patients however makes CT scan almost invariably necessary.
the use of low dose CT have partially solved the legal issues about radiation dosage.
Mesut Bulakci and Ferhat Cengel The role of radiology in diagnosis and management of drug mules: an update with new challenges and new diagnostic tools The British Journal of Radiology201689:1060 https://doi.org/10.1259/bjr.20150888 Patricia M.
Patak, “Drug mules” as a radiological challenge: Sensitivity and specificity in identifying internal cocaine in body packers,