Body packing of illicit drugs is one of the means of drug trafficking. Asymptomatic suspects may be brought in by law-enforcement officers for body search of possible drug packing inside the body. Symptomatic body packers may present with gastrointestinal obstruction or toxicity of the leaking drugs inside the packets. Management strategies are largely determined by the modes of presentation. Asymptomatic persons must be persuaded with every effort for consent to the body cavity search as well as treatment for the safe passage of any packed drugs to avoid possible complications and medico-legal sequelae. Abdominal X-rays and computed tomography can be helpful in confirming the presence of drug packets and in identifying possible packet leakage. Gastrointestinal decontamination, whole bowel irrigation, use of specific antidote as well as operative intervention may be indicated. Emergency physicians must be conversant with the medical and legal aspects of the management of these body packers.
Drug Statistics, Narcotics Division, Security Bureau, The Government of the Hong Kong Special Administrative Region. [cited 2004 May 31]. Available from: http://www.nd.gov.hk/drugstatistics_03.htm.
MarcB., BaudF.J., AelionM.J., GherardiR., Diamant-BergerO., BleryM.The cocaine body-packer syndrome: evaluation of a method of contrast study of the bowel.J Forensic Sci1990; 35(2): 345–55.
12.
JonesO.M., ShoreyB.A.Body packers: grading of risk as a guide to management and intervention.Ann R Coll Surg Engl2002; 84(2): 131–2.
13.
WatsonC.J., ThomsonH.J., JohnstonP.S.Body-packing with amphetamines–an indication for surgery.J R Soc Med1991; 84(5): 311–2.
Laws of Hong Kong, Chapter 134, Dangerous Drugs Ordinance, Section 52: powers of authorized officers. [cited 2004 Dec 5]. Available from: http://www.legislation.gov.hk/eng/home.htm.
16.
Laws of Hong Kong, Chapter 383, Hong Kong Bill of Rights Ordinance, Section 8: Hong Kong Bill of Rights, Part II. [cited 2004 Dec 5]. Available from: http://www.legislation.gov.hk/eng/home.htm.
17.
McMullenM.J.Cocaine, amphetamines and other sympathomimetics. In: RosenP., BarkinR.M., editors. Emergency Medicine - concept and clinical practice.4th ed.St Louis: Mosby Year Book; 1998: 1428–42.
18.
HierholzerJ., CordesM., TantowH., KeskeU., MaurerJ., FelixR.Drug smuggling by ingested cocaine-filled packages: conventional x-ray and ultrasound.Abdom Imaging1995; 20(4): 333–8.
19.
PinskyM.F., DucasJ., RuggereM.D.Narcotic smuggling: the double condom sign.J Can Assoc Radiol1978; 29(2): 79–81.
WilgorenJ.Misdiagnosis led to man's handcuffing, suit claims.New York Times1998 Dec 6; 62.
23.
TraubS.J., HoffmanR.S., NelsonL.S.False-positive abdominal radiography in a body packer resulting from intraabdominal calcifications.Am J Emerg Med2003; 21(7): 607–8.
VisserL., StrickerB., HoogendoornM., VinksA.Do not give paraffin to packers.Lancet1998; 352(9137): 1352.
26.
EllenhornM.J.Medical toxicology - diagnosis and treatment of human poisoning.2nd ed.Baltimore: Williams & Wilkins; 1997.
27.
HoffmanR.S., SmilksteinM.J., GoldfrankL.R.Whole bowel irrigation and the cocaine body-packer: a new approach to a common problem.Am J Emerg Med1990; 8(6): 523–7.
28.
RobinsonT., BirrerR., MandavaN., PizziW.F.Body smuggling of illicit drugs: two cases requiring surgical intervention.Surgery1993; 113(6): 709–11.
29.
DeitelM., SyedA.K.Intestinal obstruction by an unusual foreign body.CMAJ1973; 109(3): 211–2.
30.
MillerJ.S., HendrenS.K., LiscumK.R.Giant gastric ulcer in a body packer.J Trauma1998; 45(3): 617–9.
