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Radiographic features of intracorporeally smuggled liquid cocaine

Abstract

Purpose

The radiological features of intracorporeally smuggled cocaine powder are well-established. Liquid cocaine is a novel method for intracorporeal drug smuggling. We describe radiological features of liquid cocaine on abdominal plain films and computerized tomographic (CT) scans and compare them to those of cocaine powder.

Methods

Twenty-five suspected cocaine smugglers (13 males, 12 females, average age 38 years) underwent abdominal plain film radiography for drug detection between 2010 and 2014. Ten of them also underwent a CT scan. Eight were found to be smuggling cocaine powder and 17 were found to be smuggling liquid cocaine. We identified two new imaging characteristics unique to intracorporeal liquid cocaine on both plain films and CT scans, and compared them to the radiological features of cocaine powder.

Results

The radiological features of intraabdominal liquid cocaine packets on plain abdominal films (n = 17) were similar in opacity to bowel content and had an irregular shape that conformed to the intestinal contour. We identified what we termed “thin lucent lines” that were created by gas trapped between the packets. Four CT scans revealed that liquid cocaine was hyperdense compared to bowel content, that the packets had irregular shapes, and that the gas trapped between the packets formed a “jigsaw” pattern, a heretofore non-described finding that was present in all four scans.

Conclusions

Liquid cocaine has several unique imaging features that assist its detection on abdominal plain film. A CT scan can assist detection in inconclusive cases by demonstrating hyperdense irregular packets of liquid cocaine and a “jigsaw” pattern of gas between them.

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References

  1. United Nations Office on Drugs and Crime. World Drug Report, 2011.

  2. Glass JM, Scott HJ. “Surgical mules”: the smuggling of drugs in the gastrointestinal tract. J R Soc Med. 1995;88:450–3.

    CAS  PubMed Central  PubMed  Google Scholar 

  3. Traub SJ, Hoffman RS, Nelson LS. Body packing-the internal concealment of illicit drugs. N Engl J Med. 2003;349:2519–26.

    CAS  PubMed  Article  Google Scholar 

  4. Bulstrode N, Banks F, Shrotria S. The outcome of drug smuggling by “body packers”-the British experience. Ann R Coll Surg Engl. 2002;84:35–8.

    CAS  PubMed Central  PubMed  Google Scholar 

  5. Mandava N, Chang RS, Wang JH, Bertocchi M, Yrad J, Allamaneni S, et al. Establishment of a definitive protocol for the diagnosis and management of body packers (drug mules). Emerg Med J. 2011;28:98–101.

    PubMed  Article  Google Scholar 

  6. Beauverd Y, Poletti P-A, Wolff H, Ris F, Dumonceau J-M, Elger BS. A body-packer with a cocaine bag stuck in the stomach. World J Radiol. 2011;3:155–8.

    PubMed Central  PubMed  Google Scholar 

  7. Schmidt S, Hugli O, Rizzo E, Lepori D, Gudinchet F, Yersin B, et al. Detection of ingested cocaine-filled packets-diagnostic value of unenhanced CT. Eur J Radiol. 2008;67:133–8.

    PubMed  Article  Google Scholar 

  8. Maurer MH, Niehues SM, Schnapauff D, Grieser C, Rothe JH, Waldmüller D, et al. Low-dose computed tomography to detect body-packing in an animal model. Eur J Radiol. 2011;78:302–6.

    CAS  PubMed  Article  Google Scholar 

  9. Algra PR, Brogdon BG, Marugg RC. Role of radiology in a national initiative to interdict drug smuggling: the Dutch experience. AJR Am J Roentgenol. 2007;189:331–6.

    PubMed  Article  Google Scholar 

  10. Burillo-Putze G, Becker LT, Rodríguez MG, Torres JS, Nogué S. Liquid cocaine body packers. Clin Toxicol (Phila). 2012;50:522–4.

    Article  Google Scholar 

  11. Markovits N, Kurnik D, Halkin H, Guranda L, Cohen A, Katz M, et al. “Body packers” in Israel: a case series. Isr Med Assoc J. 2013;15:639–45.

    PubMed  Google Scholar 

  12. Bulakci M, Kalelioglu T, Bulakci BB, Kiris A. Comparison of diagnostic value of multidetector computed tomography and X-ray in the detection of body packing. Eur J Radiol. 2013;82:1248–54.

    PubMed  Article  Google Scholar 

  13. Hart D, Wall B. Radiation exposure of the UK population from medical and dental X-ray examinations. 2002.

  14. Bongartz G, Golding S, Jurik A. European guidelines for multislice computed tomography. Eur Comm. 2004.

  15. Pinsky MF, Ducas J, Ruggere MD. Narcotic smuggling: the double condom sign. J Can Assoc Radiol. 1978;29:79–81.

    CAS  PubMed  Google Scholar 

  16. Abdul Rashid SN, Mohamad Saini SB, Abdul Hamid S, Muhammad SJ, Mahmud R, Thali MJ, et al. Walking on thin ice! Identifying methamphetamine “drug mules” on digital plain radiography. Br J Radiol. 2014;87:20130472.

    CAS  PubMed  Article  Google Scholar 

  17. Hergan K, Kofler K, Oser W. Drug smuggling by body packing: what radiologists should know about it. Eur Radiol. 2004;14:736–42.

    PubMed  Article  Google Scholar 

  18. Flach PM, Ross SG, Ampanozi G, Ebert L, Germerott T, Hatch GM, et al. “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. 2012;81:2518–26.

    PubMed  Article  Google Scholar 

  19. Sormaala MJ, Salonen H-M, Mattila VM, Kivisaari A, Autti T. Feasibility of abdominal plain film images in evaluation suspected drug smuggler. Eur J Radiol. 2012;81:2118–21.

    PubMed  Article  Google Scholar 

  20. Poletti P-A, Canel L, Becker CD, Wolff H, Elger B, Lock E, et al. Screening of illegal intracorporeal containers (“body packing”): is abdominal radiography sufficiently accurate? A comparative study with low-dose CT. Radiology. 2012;265:772–9.

    PubMed  Article  Google Scholar 

  21. Scherr M, Peschel O, Grimm J. Low-dose CT in body-packers: delineation of body packs and radiation dose in a porcine model. Sci Med. 2014;170–8.

  22. Thali MJ, Mark D, Viner BGB. Brogdon’s forensic radiology. 2nd ed. Boca Raton: CRC Press; 2010. p. 654.

    Book  Google Scholar 

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Correspondence to Oshry Mozes.

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Mozes, O., Guranda, L., Portnoy, O. et al. Radiographic features of intracorporeally smuggled liquid cocaine. Forensic Sci Med Pathol 10, 535–542 (2014). https://doi.org/10.1007/s12024-014-9607-y

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Keywords

  • Drug smuggling
  • Cocaine
  • Liquid form
  • Powder form
  • Computerized tomography
  • Abdominal plain film