Keywords:
Emergency, Gastrointestinal tract, Conventional radiography, CT, Removal, Medico-legal issues, Foreign bodies
Authors:
F. Somma1, A. Faggian1, A. Pinto1, R. Grassi2, A. Rotondo3; 1Napoli/IT, 2Naples/IT, 3Napoli (NA)/IT
DOI:
10.1594/ecr2012/C-2223
Purpose
To illustrate the usefulness of imaging in people suspected of body packing or body stuffing by police.
In this poster we review our experience about patients carrying illegally packets of drug within their bodies,
in order to assess the correct radiological management for non compliant patients in case of ingestion or introduction of foreign bodies containing illicit and life-threatening drugs.
The aim is to improve imaging protocols both for providing a reliable proof of criminal behavior on one hand,
and on the other hand to allow a prompt diagnosis which may change the clinical management of the patient.
Introduction
In recent years,
the smuggling of illicit drugs has become a widespread practice.
The police officers usually distinguish three kinds of body smuggling: body packing,
body pushing and body stuffing.
The term of ‘body packers’ refers to international smugglers who intentionally ingest packages of drug in order to carry them across the borders and deliver that drug in a different country (1).
The ‘body pusher’ is considered the one who proceed to the introduction of drug packets in human cavities,
such as vagina or rectum,
with the same purpose of the body packers (2).
On the contrary,
the ‘body stuffer’ ingests packets of drug with the aim of concealing the illegal detention of drug from authorities in case of police control,
attempting to escape detection and arrest (1).
All these ways of drug concealment are at high risk of morbidity and mortality,
since the packet may cause complication such as bowel obstruction or may induce a fatal intoxication in case of its rupture.
So far,
plain abdominal x-ray has always been considered as the first examination to detect packets in body packer,
but it is clear that Computed Tomography (CT) is more sensitive and has a better detection capacity,
even if it is also more expensive,
time consuming and delivers more radiations (3).
At least one false negative CT report has been documented,
so far (4).