International Journal of Legal Medicine

, Volume 130, Issue 3, pp 693–709 | Cite as

Systematic review of the toxicological and radiological features of body packing

  • Simone Cappelletti
  • Daria PiacentinoEmail author
  • Gabriele Sani
  • Edoardo Bottoni
  • Paola Antonella Fiore
  • Mariarosaria Aromatario
  • Costantino Ciallella


Body packing is the term used for the intracorporeal concealment of illicit drugs, mainly cocaine, heroin, methamphetamine, and cannabinoids. These drugs are produced in the form of packages and are swallowed or placed in various anatomical cavities and body orifices. Basing on these two ways of transportation a distinction between body stuffers and body pushers can be made, with the former described as drug users or street dealers who usually carry small amounts of drugs and the latter as professional drug couriers who carry greater amounts of drugs. A review of the literature regarding body packing is presented, with the aim to highlight the toxicological and radiological features related to this illegal practice. Raising awareness about the encountered mean body levels of the drugs and the typical imaging signs of the incorporated packages could be useful for clinicians and forensic pathologists to (a) identify possible unrecognized cases of body packing and (b) prevent the serious health consequences and deaths frequently occurring after the packages’ leakage or rupture or the packages’ mass obstructing the gastrointestinal lumen.


Body packing Toxicology Radiology Imaging Health consequences Death 



The authors wish to thank Mr. Fabrizio Fioravanti, librarian of the Institute of Legal Medicine “Cesare Gerin,” Department of Anatomical, Histological, Forensic Medicine and Orthopedic Sciences, “Sapienza” University of Rome, for making accessible precious bibliographical material.

Compliance with ethical standards

Role of the funding source

This study is part of the FIRB project code RBFR12LD0W_002 and has been funded by a grant of the Italian Ministry of Research.

Supplementary material

414_2015_1310_MOESM1_ESM.docx (33 kb)
ESM 1 (DOCX 32.9 kb)
414_2015_1310_MOESM2_ESM.docx (53 kb)
ESM 2 (DOCX 60.8 kb)


  1. 1.
    Deitel M, Syed AK (1973) Intestinal obstruction by an unusual foreign body. Can Med Assoc J 109(4):211–212PubMedPubMedCentralGoogle Scholar
  2. 2.
    June R, Aks SE, Keys N, Wahl M (2000) Medical outcome of cocaine bodystuffers. J Emerg Med 18:221–224PubMedCrossRefGoogle Scholar
  3. 3.
    Schmidt S, Hugli O, Rizzo E, Lepori D, Gudinchet F, Yersin B, Schnyder P, Meuwly JY (2008) Detection of ingested cocaine-filled packets: diagnostic value of unenhanced CT. Eur J Radiol 67(1):133–138PubMedCrossRefGoogle Scholar
  4. 4.
    Glass JM, Scott HJ (1995) Surgical mules: the smuggling of drugs in the gastrointestinal tract. J R Soc Med 88:450–453PubMedPubMedCentralGoogle Scholar
  5. 5.
    Bogusz MJ, Althoff H, Erkens M, Maier RD, Hofmann R (1995) Internally concealed cocaine: analytical and diagnostic aspects. J Forensic Sci 40(5):811–815PubMedCrossRefGoogle Scholar
  6. 6.
    Médiouni Z, Steffen M, Bécour B (2013) Incidentalomas revealed by abdominopelvic computed tomography scans performed in body packers. Am J Forensic Med Pathol 34(4):331–334PubMedCrossRefGoogle Scholar
  7. 7.
    Wetli CV, Mittlemann RE (1981) The “body packer syndrome”—toxicity following ingestion of illicit drugs packaged for transportation. J Forensic Sci 26(3):492–500PubMedGoogle Scholar
  8. 8.
    Thompson AC, Terry RM (1989) Cannabis-resin foreign body in the ear. N Engl J Med 320(26):1758PubMedGoogle Scholar
  9. 9.
    Birchall MA, Marres HP (1989) ‘Ear packing’ in drug abusers. BMJ 298:214Google Scholar
  10. 10.
    Prosser JM, Hoffman RS (2006) Cocaine. In: Nelson LS, Lewin NA, Howland MA, Hoffman RS, Goldfrank LR, Flomenbaum NE (eds) Goldfrank’s toxicologic emergencies, 9th edn. McGraw Hill, New York, pp 1091–1102Google Scholar
  11. 11.
    Gherardi RK, Baud FJ, Leporc P, Marc B, Dupeyron JP, Diamant-Berger O (1988) Detection of drugs in the urine of body-packers. Lancet 1(8594):1076–1078PubMedCrossRefGoogle Scholar
  12. 12.
    Bulstrode N, Banks F, Shrotria S (2002) The outcome of drug smuggling by ‘body-packers’—the British experience. Ann R Coll Surg Engl 84:35–38PubMedPubMedCentralGoogle Scholar
  13. 13.
    van Geloven AA, van Lienden KP, Gouma DJ (2002) Bodypacking—an increasing problem in The Netherlands: conservative or surgical treatment? Eur J Surg 168(7):404–409PubMedCrossRefGoogle Scholar
  14. 14.
    Traub SJ, Hoffman RS, Nelson LS (2003a) Body packing—the internal concealment of illicit drugs. N Engl J Med 349(26):2519–2526PubMedCrossRefGoogle Scholar
  15. 15.
    Beno S, Calello D, Baluffi A, Henretig FM (2005) Pediatric body packing: drug smuggling reaches a new low. Pediatr Emerg Care 21(11):744–746PubMedCrossRefGoogle Scholar
  16. 16.
    Traub SJ, Kohn GL, Hoffman RS, Nelson LS (2003b) Pediatric “body-packing”. Arch Pediatr Adolesc Med 157:174–177PubMedCrossRefGoogle Scholar
  17. 17.
    Annotations (1940) A new way of smuggling narcotics. The Lancet 235(6080):464Google Scholar
  18. 18.
    Chakrabarty A, Hydros S, Puliyel JM (2006) Smuggling contraband drugs using paediatric “body packers”. Arch Dis Child 91:51PubMedPubMedCentralCrossRefGoogle Scholar
  19. 19.
    Greenberg MI, Shrethra M (2000) Management of the pregnant body packer. J Toxicol, Clin Toxicol 38:176–177Google Scholar
  20. 20.
    Cordero DR, Medina C, Helfgott A (2006) Cocaine body packing in pregnancy. Ann Emerg Med 48(3):323–325PubMedCrossRefGoogle Scholar
  21. 21.
    Cawich SO, Hassranah D, Pooran S, Dan D, Narayansingh V (2015) Complicated acute appendicitis? An unusual differential. Trop Doct 45(1):49–51PubMedCrossRefGoogle Scholar
  22. 22.
    Hergan K, Kofler K, Oser W (2004) Drug smuggling by body packing: what radiologists should know about it. Eur Radiol 14:736–742PubMedCrossRefGoogle Scholar
  23. 23.
    Grimm J, Wudy R, Ziegeler E, Wirth S, Uhl M, Reiser MF, Scherr M (2014) Differentiation of heroin and cocaine using dual-energy CT—an experimental study. Int J Legal Med 128(3):475–482PubMedCrossRefGoogle Scholar
  24. 24.
    de Bakker JK, Nanayakkara PW, Geeraedts LM Jr, de Lange ES, Mackintosh MO, Bonjer HJ (2012) Body packers: a plea for conservative treatment. Langenbecks Arch Surg 397(1):125–130PubMedPubMedCentralCrossRefGoogle Scholar
  25. 25.
    Silverberg D, Menes T, Kim U (2006) Surgery for “body packers”—a 15-year experience. World J Surg 30(4):541–546PubMedCrossRefGoogle Scholar
  26. 26.
    Booker RJ, Smith JE, Rodger MP (2009) Packers, pushers and stuffers—managing patients with concealed drugs in UK emergency departments: a clinical and medicolegal review. Emerg Med J 26(5):316–320PubMedCrossRefGoogle Scholar
  27. 27.
    McCarron MM, Wood JD (1983) The cocaine ‘body packer’ syndrome. Diagnosis and treatment. JAMA 250(11):1417–1420PubMedCrossRefGoogle Scholar
  28. 28.
    Caruana DS, Weinbach B, Goerg D, Gardner LB (1984) Cocaine-packet ingestion. Diagnosis, management, and natural history. Ann Intern Med 100(1):73–74PubMedCrossRefGoogle Scholar
  29. 29.
    Gómez Antúnez M, Cuenca Carvajal C, Farfán Sedano A, Villalba MV, del Toro CJ, García Castaño J (1998) Complications of intestinal transporting of cocaine packets. Study of 215 cases. Med Clin (Barc) 111(9):336–337Google Scholar
  30. 30.
    Pollack CV Jr, Biggers DW, Carlton FB Jr, Achord JL, Cranston PE, Eggen JT, Griswold JA (1992) Two crack cocaine body stuffers. Ann Emerg Med 21(11):1370–1380PubMedCrossRefGoogle Scholar
  31. 31.
    Pidoto RR, Agliata AM, Bertolini R, Mainini A, Rossi G, Giani G (2002) A new method of packaging cocaine for international traffic and implications for the management of cocaine body packers. J Emerg Med 23(2):149–153PubMedCrossRefGoogle Scholar
  32. 32.
    Wilcher G (2011) Drug-related deaths with evidence of intracorporeal drug concealment at autopsy: five case reports. Am J Forensic Med Pathol 32(4):314–318PubMedCrossRefGoogle Scholar
  33. 33.
    Aldrighetti L, Paganelli M, Giacomelli M, Villa G, Ferla G (1996) Conservative management of cocaine-packet ingestion: experience in Milan, the main Italian smuggling center of South American cocaine. Panminerva Med 38(2):111–116PubMedGoogle Scholar
  34. 34.
    Reginelli A, Russo A, Urraro F, Maresca D, Martiniello C, D'Andrea A, Brunese L, Pinto A (2015) Imaging of body packing: errors and medico-legal issues. Abdom Imaging 40(7):2127–2142PubMedCrossRefGoogle Scholar
  35. 35.
    Shahnazi M, Sanei Taheri M, Pourghorban R (2011) Body packing and its radiologic manifestations: a review article. Iran J Radiol 8(4):205–210PubMedPubMedCentralCrossRefGoogle Scholar
  36. 36.
    Sribanditmongkol P, Supasingsiripreecha W, Thampitak S, Junkuy A (2006) Fatal heroin intoxication in body packers in northern Thailand during the last decade: two case reports. J Med Assoc Thai 89(1):106–110PubMedGoogle Scholar
  37. 37.
    Clément R, Fornes P, Lecomte D (2001) The body packer syndrome. Presse Med 30:264–267PubMedGoogle Scholar
  38. 38.
    Gill JR, Graham SM (2002) Ten years of “body packers” in New York City: 50 deaths. J Forensic Sci 47:843–846PubMedGoogle Scholar
  39. 39.
    Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol 62(10):1006–1012PubMedCrossRefGoogle Scholar
  40. 40.
    Cawich SO, Downes R, Martin AC, Evans NR, Mitchell DI, Williams E (2010) Colonic perforation: a lethal consequence of cannabis body packing. J Forensic Leg Med 17(5):269–271PubMedCrossRefGoogle Scholar
  41. 41.
    Barnett JM, Codd G (2002) Sudden, unexpected death of a cannabis bodypacker, due to perforation of the rectum. J Clin Forensic Med 9(2):82–84PubMedCrossRefGoogle Scholar
  42. 42.
    Nichols GR 2nd, Davis GJ (1992) Body packing with a twist. Death of a salesman. Am J Forensic Med Pathol 13(2):142–145PubMedCrossRefGoogle Scholar
  43. 43.
    Spadari M, Canioni D, Gregoire E, Drouet G, Bourdon JH, Arditti J, Micallef J (2011) Cannabis body packing: two case reports. Clin Toxicol (Phila) 49(9):862–864CrossRefGoogle Scholar
  44. 44.
    Amon CA, Tate LG, Wright RK, Matusiak W (1986) Sudden death due to ingestion of cocaine. J Anal Toxicol 10(5):217–218PubMedCrossRefGoogle Scholar
  45. 45.
    Moffat AC, Osselton MD, Widdop B, Watts J (2011) Cocaine. In: Moffat AC, Osselton MD, Widdop B, Watts J (eds) Clarke’s analysis of drugs and poisons, 4th edn. Pharmaceutical Press, London, pp 1152–1155Google Scholar
  46. 46.
    Fineschi V, Centini F, Monciotti F, Turillazzi E (2002) The cocaine “body stuffer” syndrome: a fatal case. Forensic Sci Int 126:7–10PubMedCrossRefGoogle Scholar
  47. 47.
    Marchei E, Colone P, Nastasi GG, Calabrò C, Pellegrini M, Pacifici R, Zuccaro P, Pichini S (2008) On-site screening and GC-MS analysis of cocaine and heroin metabolites in body-packers urine. J Pharm Biomed Anal 48(2):383–387PubMedCrossRefGoogle Scholar
  48. 48.
    Malbrain ML, Neels H, Vissers K, Demedts P, Verbraeken H, Daelemans R, Wauters A (1994) A massive, near-fatal cocaine intoxication in a body-stuffer. Case report and review of the literature. Acta Clin Belg 49(1):12–18PubMedGoogle Scholar
  49. 49.
    Fucci N (2004) Phenacetin and cocaine in a body packer. Forensic Sci Int 141(1):59–61PubMedCrossRefGoogle Scholar
  50. 50.
    Meissner C, Recker S, Reiter A, Friedrich HJ, Oehmichen M (2002) Fatal versus non-fatal heroin “overdose”: blood morphine concentrations with fatal outcome in comparison to those of intoxicated drivers. Forensic Sci Int 130(1):49–54PubMedCrossRefGoogle Scholar
  51. 51.
    Joynt BP, Mikhael NZ (1985) Sudden death of a heroin body packer. J Anal Toxicol 9(5):238–240PubMedCrossRefGoogle Scholar
  52. 52.
    Nihira M, Hayashida M, Ohno Y, Inuzuka S, Yokota H, Yamamoto Y (1998) Urinalysis of body packers in Japan. J Anal Toxicol 22(1):61–65PubMedCrossRefGoogle Scholar
  53. 53.
    Uges DRA (1996) Therapeutic and toxic drug concentration. TIAFT Bull 26Google Scholar
  54. 54.
    Nagata T (1983) Signification of methamphetamine concentration in body fluids and tissues. Jpn J Legal Med 37:513–518Google Scholar
  55. 55.
    Logan BK, Fligner CL, Haddix T (1998) Cause and manner of death in fatalities involving methamphetamine. J Forensic Sci 43(1):28–34PubMedGoogle Scholar
  56. 56.
    Uekusa K, Hayashida M, Saito N, Mashiko K, Hara K, Waters B, Ohno Y (2013) Methamphetamine and amphetamine concentrations in survivors of body-packer syndrome in Japan. Forensic Sci Int 227(1-3):45–47PubMedCrossRefGoogle Scholar
  57. 57.
    Takekawa K, Ohmori T, Kido A, Oya M (2007) Methamphetamine body packer: acute poisoning death due to massive leaking of methamphetamine. J Forensic Sci 52(5):1219–1222PubMedCrossRefGoogle Scholar
  58. 58.
    Kashani J, Ruha AM (2004) Methamphetamine toxicity secondary to intravaginal body stuffing. J Toxicol, Clin Toxicol 42(7):987–989CrossRefGoogle Scholar
  59. 59.
    Bin Abdul Rashid SN, Rahim AS, Thali MJ, Flach PM (2013) Death by ‘ice’: fatal methamphetamine intoxication of a body packer case detected by postmortem computed tomography (PMCT) and validated by autopsy. Forensic Sci Med Pathol 9(1):82–87PubMedCrossRefGoogle Scholar
  60. 60.
    Karhunen PJ, Suoranta H, Penttila A, Pitkaranta P (1991) Pitfalls in the diagnosis of drug smuggler’s abdomen. J Forensic Sci 36:397–402PubMedGoogle Scholar
  61. 61.
    Olmedo R, Nelson L, Chu J, Hoffman RS (2001) Is surgical decontamination definitive treatment of “body-packers”? Am J Emerg Med 19(7):593–596PubMedCrossRefGoogle Scholar
  62. 62.
    Burillo-Putze G, Becker LT, Rodríguez MG, Torres JS, Nogué S (2012) Liquid cocaine body packers. Clin Toxicol (Phila) 50(6):522–524CrossRefGoogle Scholar
  63. 63.
    Berger FH, Nieboer KH, Goh GS, Pinto A, Scaglione M (2015) Body packing: a review of general background, clinical and imaging aspects. Radiol Med 120(1):118–132PubMedCrossRefGoogle Scholar
  64. 64.
    Niewiarowski S, Gogbashian A, Afaq A, Kantor R, Win Z (2010) Abdominal X-ray signs of intra-intestinal drug smuggling. J Forensic Leg Med 17(4):198–202PubMedCrossRefGoogle Scholar
  65. 65.
    Pinto A, Reginelli A, Pinto F, Sica G, Scaglione M, Berger FH, Romano L, Brunese L (2014) Radiological and practical aspects of body packing. Br J Radiol 87(1036):20130500PubMedPubMedCentralCrossRefGoogle Scholar
  66. 66.
    Walter BM, Martignoni M, Säckl J, Felgenhauer N, Eyer F, Tratzl V, Schmid RM, von Delius S (2012) A curious case of body packing: impaction of cocaine capsules in a colostomy exit. Forensic Toxicol 30:199–201CrossRefGoogle Scholar
  67. 67.
    Lee K, Koehn M, Rastegar RF, van Hoorn F, Roy E, Berger FH, Nicolaou S (2012) Body packers: the ins and outs of imaging. Can Assoc Radiol J 63(4):318–322PubMedCrossRefGoogle Scholar
  68. 68.
    Wilgoren J (1998) Misdiagnosis led to man’s handcuffing, suit claims., New York Times, Accessed 17 April 2015Google Scholar
  69. 69.
    Traub SJ, Hoffman RS, Nelson LS (2003c) False positive abdominal radiography in a body packer resulting from intraabdominal calcifications. Am J Emerg Med 21:607–608PubMedCrossRefGoogle Scholar
  70. 70.
    Kaneko H, Tomomasa T, Kubota Y, Todokoro M, Kato M, Miyazawa R (2004) Pharmacobezoars complicating treatment with sodium alginate. J Gastroenterol 39:69–71PubMedCrossRefGoogle Scholar
  71. 71.
    Algra PR, Brogdon BG, Marugg RC (2007) Role of radiology in a national initiative to interdict drug smuggling: the Dutch experience. AJR Am J Roentgenol 189(2):331–336PubMedCrossRefGoogle Scholar
  72. 72.
    Bulakci M, Kalelioglu T, Bulakci BB, Kiris A (2013a) Comparison of diagnostic value of multidetector computed tomography and X-ray in the detection of body packing. Eur J Radiol 82(8):1248–1254PubMedCrossRefGoogle Scholar
  73. 73.
    Fainsinger MH (1977) Unusual foreign bodies in bowel. JAMA 237(20):2225–2226PubMedCrossRefGoogle Scholar
  74. 74.
    Fishbain DA, Wetli CV (1981) Cocaine intoxication, delirium and death in a body packer. Ann Emerg Med 10:531–532PubMedCrossRefGoogle Scholar
  75. 75.
    Kersschot EA, Beaucourt LE, Degryse HR, De Schepper AM (1985) Roentgenographical detection of cocaine smuggling in the alimentary tract. Rofo 142(3):295–298PubMedCrossRefGoogle Scholar
  76. 76.
    Hartoko TJ, Demey HE, De Schepper AM, Beaucourt LE, Bossaert LL (1988) The body packer syndrome—cocaine smuggling in the gastro-intestinal tract. Klin Wochenschr 66(22):1116–1120PubMedCrossRefGoogle Scholar
  77. 77.
    Gherardi RK, Marc B, Alberti X, Baud F, Diamant-Berger O (1990) A cocaine body packer with normal abdominal plain radiograms. Value of drug detection in urine and contrast study of the bowel. Am J Forensic Med Pathol 11(2):154–157PubMedCrossRefGoogle Scholar
  78. 78.
    Eng JG, Aks SE, Waldron R, Marcus C, Issleib S (1999) False-negative abdominal CT scan in a cocaine body stuffer. Am J Emerg Med 17:702–704PubMedCrossRefGoogle Scholar
  79. 79.
    Sengupta A, Page P (2008) Window manipulation in diagnosis of body packing using computed tomography. Emerg Radiol 15(3):203–205PubMedCrossRefGoogle Scholar
  80. 80.
    Yang RM, Li L, Feng J, Lai SS, Lin BQ, Yu T, Ye XH, Xu YK (2009) Heroin body packing: clearly discerning drug packets using CT. South Med J 102(5):470–475PubMedCrossRefGoogle Scholar
  81. 81.
    Beauverd Y, Poletti PA, Wolff H, Ris F, Dumonceau JM, Elger BS (2011) A body-packer with a cocaine bag stuck in the stomach. World J Radiol 3(6):155–158PubMedPubMedCentralGoogle Scholar
  82. 82.
    Marc B, Baud FJ, Aelion MJ, Gherardi R, Diamant-Berger O, Blery M, Bismuth C (1990) The cocaine body-packer syndrome: evaluation of a method of contrast study of the bowel. J Forensic Sci 35(2):345–355PubMedCrossRefGoogle Scholar
  83. 83.
    Flach PM, Ross SG, Ampanozi G, Ebert L, Germerott T, Hatch GM, Thali MJ, Patak MA (2012) “Drug mules” as a radiological challenge: sensitivity and specificity in identifying internal cocaine in body packers, body pushers and body stuffers by computed tomography, plain radiography and Lodox. Eur J Radiol 81(10):2518–2526PubMedCrossRefGoogle Scholar
  84. 84.
    Hierholzer J, Cordes M, Tantow H, Keske U, Mäurer J, Felix R (1995) Drug smuggling by ingested cocaine-filled packages: conventional x-ray and ultrasound. Abdom Imaging 20(4):333–338PubMedCrossRefGoogle Scholar
  85. 85.
    Alzen G, Banning S, Gunther R (1987) Sonographic detectability of narcotic drug containers in the gastrointestinal tract. Experimental research in the dog. Rofo 146(5):544–547PubMedCrossRefGoogle Scholar
  86. 86.
    Cengel F, Bulakci M, Selcuk T, Savas Y, Ceyhan M, Kocak A, Bilgili CO (2015) The role of ultrasonography in the imaging of body packers comparison with CT: a prospective study. Abdom Imaging 24. [Epub ahead of print]Google Scholar
  87. 87.
    Shahnazi M, Hassanian-Moghaddam H, Gachkar L, Ahmadi N, Zamani N, Bahrami-Motlagh H, Faghihi Langroudi T, Arjmand Shabestari A, Mohammad Alizadeh A (2015) Comparison of abdominal computed tomography with and without oral contrast in diagnosis of body packers and body stuffers. Clin Toxicol (Phila) 11:1–8. [Epub ahead of print]Google Scholar
  88. 88.
    Brogdon BG, Vogel H, Algra PR (2010) Smuggling/border control. In: Thali MJ, Viner MD, Brogdon BG (eds) Brogdon’s forensic radiology, 2nd edn. CRC Press, Taylor & Francis Group, Washington D.C., pp 297–310CrossRefGoogle Scholar
  89. 89.
    Poletti PA, Canel L, Becker CD, Wolff H, Elger B, Lock E, Sarasin F, Bonfanti MS, Dupuis-Lozeron E, Perneger T, Platon A (2012) Screening of illegal intracorporeal containers (“body packing”): is abdominal radiography sufficiently accurate? A comparative study with low-dose CT. Radiology 265(3):772–779PubMedCrossRefGoogle Scholar
  90. 90.
    Hahn IH, Hoffman RS, Nelson LS (2004) Contrast CT scan fails to detect the last heroin packet. J Emerg Med 27(3):279–283PubMedCrossRefGoogle Scholar
  91. 91.
    Union E (1996) Council Directive 96/29/Euratom of 13 May 1996 laying down basic safety standards for the protection of the health of workers and the general public against the dangers of ionizing radiation., Access via, Google Scholar
  92. 92.
    Wackerle B, Rupp N, von Clarmann M, Kahn T, Heller H, Feurbach S (1986) Demonstration of narcotic packages in “body packers” by various imaging methods. In vitro and in vivo investigations. Fortschr Roengenstr 145:274–277CrossRefGoogle Scholar
  93. 93.
    Ab Hamid S, Abd Rashid SN, Mohd Saini S (2012) Characteristic imaging features of body packers: a pictorial essay. Jpn J Radiol 30(5):386–392PubMedCrossRefGoogle Scholar
  94. 94.
    Bulakci M, Ozbakir B, Kiris A (2013b) Detection of body packing by magnetic resonance imaging: a new diagnostic tool? Abdom Imaging 38(3):436–441PubMedCrossRefGoogle Scholar
  95. 95.
    Hayhurst C (2014) Caring for adult patients suspected of having concealed illicit drugs. The College of Emergency Medicine.
  96. 96.
    Jordan MT, Bryant SM, Aks SE, Wahl M (2009) A five-year review of the medical outcome of heroin body stuffers. J Emerg Med 36(3):250–256PubMedCrossRefGoogle Scholar
  97. 97.
    Choudhary AM, Taubin H, Gupta T, Roberts I (1998) Endoscopic removal of a cocaine packet from the stomach. J Clin Gastroenterol 27(2):155–156PubMedCrossRefGoogle Scholar
  98. 98.
    Goertemoeller S, Behrman A (2006) The risky business of body packers and body stuffers. J Emerg Nurs 32(6):541–544PubMedCrossRefGoogle Scholar
  99. 99.
    Klein C, Balash Y, Pollak L, Hiss J, Rabey MJ (2000) Body packer: cocaine intoxication, causing death, masked by concomitant administration of major tranquilizers. Eur J Neurol 7(5):555–558PubMedCrossRefGoogle Scholar
  100. 100.
    Robinson T, Birrer R, Mandava N, Pizzi WF (1993) Body smuggling of illicit drugs: two cases requiring surgical intervention. Surgery 113:709–711PubMedGoogle Scholar
  101. 101.
    Hutchins KD, Pierre-Louis PJ, Zaretski L, Williams AW, Lin RL, Natarajan GA (2000) Heroin body packing: three fatal cases of intestinal perforation. J Forensic Sci 45(1):42–47PubMedCrossRefGoogle Scholar
  102. 102.
    Wetli CV, Rao A, Rao VJ (1997) Fatal heroin body packing. Am J Forensic Med Pathol 18:312–318PubMedCrossRefGoogle Scholar
  103. 103.
    Dunne JW (1983) Drug smuggling by internal bodily concealment. Med J Aust 2(9):436–439PubMedGoogle Scholar
  104. 104.
    Johnson JA, Landreneau RJ (1991) Esophageal obstruction and mediastinitis: a hard pill to swallow for drug smugglers. Am Surg 57:723–726PubMedGoogle Scholar
  105. 105.
    Duenas-Laita A, Nogue S, Burillo-Putze G (2004) Body packing. N Engl J Med 350:1260e1Google Scholar
  106. 106.
    Soriano-Perez MJ, Serrano-Carrillo JL, Marin-Montin I, Cruz-Caballero A (2009) Hashish body packing: a case report. Case Rep Med 2009:712573PubMedPubMedCentralGoogle Scholar
  107. 107.
    Beckley I, Ansari NA, Khwaja HA, Mohsen Y (2009) Clinical management of cocaine body packers: the Hillingdon experience. Can J Surg 52(5):417–421PubMedPubMedCentralGoogle Scholar
  108. 108.
    Cobaugh DJ, Schneider SM, Benitez JG, Donahoe MP (1997) Cocaine balloon aspiration: successful removal with bronchoscopy. Am J Emerg Med 15(5):544–546PubMedCrossRefGoogle Scholar
  109. 109.
    Dabby R, Djaldetti R, Gilad R, Herman O, Frand J, Sadeh M, Watemberg N (2006) Acute heroin-related neuropathy. J Peripher Nerv Syst 11(4):304–309PubMedCrossRefGoogle Scholar
  110. 110.
    Warner-Smith M, Darke S, Day C (2002) Morbidity associated with non-fatal heroin overdose. Addiction 97(8):963–967PubMedCrossRefGoogle Scholar
  111. 111.
    Simioni V, Capone JG, Sette E, Sensi M, Tola MR, Granieri E, Tugnoli V (2014) Acute painful neuropathy in a heroin body packer. Pain Med 15(7):1236–1237PubMedCrossRefGoogle Scholar
  112. 112.
    European Union (1997) Council Directive 97/43/Euratom of 30 June 1997 on health protection of individuals against the dangers of ionizing radiation in relation to medical exposure and repealing Directive 84/466/Euratom. Access via
  113. 113.
    Markovits N, Kurnik D, Halkin H, Guranda L, Cohen A, Katz M, Olchovsky D, Mayan H, Loebstein R (2013) “Body packers” in Israel: a case series. Isr Med Assoc J 15(10):639–645PubMedGoogle Scholar
  114. 114.
    Neves FF, Cupo P, Muglia VF, Junior JE, Nogueira-Barbosa MH, Pazin-Filho A (2013) Body packing by rectal insertion of cocaine packets: a case report. BMC Res Notes 6:178PubMedPubMedCentralCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Simone Cappelletti
    • 1
  • Daria Piacentino
    • 2
    Email author
  • Gabriele Sani
    • 2
  • Edoardo Bottoni
    • 1
  • Paola Antonella Fiore
    • 1
  • Mariarosaria Aromatario
    • 1
  • Costantino Ciallella
    • 1
  1. 1.Department of Anatomical, Histological, Forensic Medicine and Orthopedic Sciences“Sapienza” University of RomeRomeItaly
  2. 2.NESMOS (Neuroscience, Mental Health, and Sensory Organs) Department, School of Medicine and Psychology“Sapienza” University of RomeRomeItaly

Personalised recommendations