Body packing is defined as the trafficking of illicit drugs within the gastrointestinal tract (GI tract).
Daily,
illegal drugs are imported through major ports of entry in many countries.
In recent years,
we have observed in the emergency room an increasing number of cases in which there is suspicion of body packers,
probably due to an increase in international traffic of drugs and/or intensification of security measures at airports.
The body packer is a person who is a carries intra-abdominal foreign bodies such as latex sheath (condom or balloon),
rubber glove fingers or cellophane filled with tightly packed illicit drugs (cocaine,
heroin,
cannabis,
amphetamines,
or other substances),
for purposes of smuggling.
Cocaine,
because of its popularity among drug users and its potential for high profit to the smuggler,
has become a major item in the list of drugs brought into many countries illegally.
The body packer can carry as many as 200 packets by swallowing three separate loadings four hours apart to fill the entire GI tract,
just before takeoff.
Parasympathomimetic drugs may be used to inhibit peristalsis and delay defecation during the flight.
The patient,
once reached its destination,
will use oral laxatives or enemas to expel the ingested packages.
Clinically body packers can be broadly classified into three groups:
a) Asymptomatic;
b) Body Packer intestinal occlusion syndrome;
c) Body Packer syndrome secondary to cocaine intoxication;
The "Body Packer syndrome" itself is defined as an intestinal obstruction and/or secondary intoxication due to transport of drug packages in the GI tract.
It is imperative for radiologists to understand and familiarize themselves with the radiological signs of ingested drug packets.
Radiologists must also be aware of their legal responsibilities when interpreting examinations of suspected smugglers.
Radiological measures may also be required also when suspected smugglers present with foreign-body induced intestinal obstruction or drug toxicity due to the rupture or leakage of drug packets.
At present,
drug packets are machine produced and therefore uniform in size and weight.
Improvements in packaging and increasing sophistication of traffickers add to detection difficulty.
The new type of packaging is a special challenge to customs,
they are not always visible (radio-opaque) on abdominal radiographs.