Keywords:
Abdomen, Emergency, Gastrointestinal tract, CT, Image manipulation / Reconstruction, Diagnostic procedure, Technology assessment, Medico-legal issues, Foreign bodies, Forensics
Authors:
J. Rey, V. Mino, A.-S. KNOEPFLI, J.-Y. Meuwly, F. R. Verdun, R. A. MEULI, S. Schmidt; Lausanne/CH
DOI:
10.1594/ecr2012/C-1138
Purpose
We nowadays observe a steadily increasing worldwide abuse of cocaine with medico legal and social consequences.
To smuggle and hide these narcotics the gastrointestinal (GI) tract is often being used as a vehicle (1).
The terms used for intracorporeal concealment of illicit drugs are « body packer »,
« body pusher « and « body stuffer » (2-4).
Body packers swallow large bags (2-8cm) prior to cross international borders,
in order to retrieve them after arrival.
They are professional dealers with the main goal to transport narcotics over long distances,
thus also called mules (2-4).
Body pushers are regional smugglers who hide several drug-filled packets in the vagina or in the rectum (2).
Body stuffers,
also called «mini packers»,
are usually local street dealers,
who swallow one or several little cocaine-filled packets (CFP) (8-10 mm,
Fig.
1,
(5)) in order to conceal this small amount of cocaine by fear of police’s arrest.
In the daily practice unenhanced abdominal MDCT is increasingly being performed for body stuffers’ management mainly indicated by legal purposes,
but also for medical reasons,
since the leakage of CFP can trigger lethal complications (4-7).
However,
MDCT is associated with a higher radiation dose than conventional abdominal radiography which remains the established imaging modality for the investigation of body packers (8).
Nevertheless,
the latter generally incorporate bigger,
thus more easily detected packets of narcotics than body stuffers do.
To our knowledge,
the diagnostic value of MDCT for the detection of small CFP in body stuffers has not yet been exactly evaluated,
especially in comparison with a real reference standard.
Thus,
the purpose of our study was
- To assess the diagnostic value of abdominal MDCT performed in body stuffers for the detection of ingested CFP
- To compare the techniqual quality of the images,
in terms of spatial and contrast resolution and artefacts,
as well as the diagnostic value of axial MDCT obtained by filtered back projection (FBP) with adaptive statistical iterative images (30% ASIR and 60% ASIR) concerning body stuffers with ingested CFP