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Surgical treatment in cocaine body packers and body pushers

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Objective

Body packers smuggle cocaine by swallowing containers filled with the drugs, whilst body pushers conceal the containers in the rectum or vagina. In a collaborative effort between the Department of General Surgery, two major airports and Poisons Centre, we performed a retrospective study to develop an algorithm for the treatment of ruptured cocaine-filled containers.

Materials and methods

The data of all cocaine body packers and body pushers who were identified at the airports of Frankfurt and Paris from 1985 to 2002 were evaluated concerning incidence, demographics and surgical aspects.

Results

From 1985 to 2002, 312 body pushers and 4,660 body packers were identified. The sex ratio was 1:1. Sixty-four “mules” (1.4%) developed life-threatening symptoms of cocaine overdose after the rupture of a container. In 20 patients, an emergency laparotomy was performed and the containers were removed; all of these patients survived. Forty-four body packers died before surgical treatment could be performed. Only one body pusher required medical attention.

Conclusion

Cocaine overdose can be life-threatening. If the cause is the rupture of a container in a body packer, the only possible treatment is immediate laparotomy for the removal of the container.

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References

  1. Fishbain DA, Wetli CV (1981) Cocaine intoxication, delirium, and death in a body packer. Ann Emerg Med 10:531–532

    Article  CAS  PubMed  Google Scholar 

  2. Wetli CV, Mittlemann RE (1981) The “body packer syndrome”—toxicity following ingestion of illicit drugs packaged for transportation. J Forensic Sci 26:492–500

    CAS  PubMed  Google Scholar 

  3. McCarron MM, Wood JD (1983) The cocaine ‘body packer’ syndrome. Diagnosis and treatment. JAMA 250:1417–1420

    Article  CAS  PubMed  Google Scholar 

  4. Haugen OA, Dalaker M, Svindland A (1994) Smuggling of narcotics in body cavities. Tidsskr Nor Laegeforen 10:2501–2502

    Google Scholar 

  5. Gill JR, Graham SM (2002) Ten years of “body packers” in New York City: 50 deaths. J Forensic Sci 47(4):843–846

    Article  PubMed  Google Scholar 

  6. MAHSAN Diagnostika (2005) MAHSAN catalogue for quick tests, p 42

  7. Beermann R, Nunez D Jr, Wetli CV (1986) Radiographic evaluation of the cocaine smuggler. Gastrointest Radiol 11:351–354

    Article  Google Scholar 

  8. Hartoko DJ, Demey HE, De Schepper AM, Beaucourt LE, Bossaert LL (1988) The body packer syndrome—cocaine smuggling in the gastro-intestinal tract. Klin Wochenschr 66:1116–1120

    Article  CAS  PubMed  Google Scholar 

  9. Marc B, Baud FJ, Aelion MJ, Gherardi R et al (1990) The cocaine body-packer syndrome: evaluation of a method of contrast study of the bowel. J Forensic Sci 35:345–355

    Article  CAS  PubMed  Google Scholar 

  10. Gherardi R, 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 11:154–157

    Article  CAS  PubMed  Google Scholar 

  11. Hierholzer J, Cordes M, Tantow H, Keske U, Maurer J, Felix R (1995) Drug smuggling by ingested cocaine-filled packages: conventional X-ray and ultrasound. Abdom Imaging 20(4):333–338

    Article  CAS  PubMed  Google Scholar 

  12. Hoffman RS, Smilkstein MJ, Goldfrank LR (1990) Whole bowel irrigation and the cocaine body-packer: a new approach to a common problem. Am J Emerg Med 8:523–527

    Article  CAS  PubMed  Google Scholar 

  13. Gomez Antunez M, Cuenca Carvajal C, Farfan Sedano A, Villalba MV, del Toro Cervera J, Garcia Castano J (1998) Complications of intestinal transporting of cocaine packets. Study of 215 cases. Med Clin (Barc) 26:336–337

    Google Scholar 

  14. John H, Schoenenberger R, Renner N, Ritz R (1992) Cocaine poisoning from transport of the drug in the gastrointestinal tract (the body-packer syndrome). Dtsch Med Wochenschr 117:1952–1955

    Article  CAS  PubMed  Google Scholar 

  15. John H, Renner N, Schoenenberger R, Harder F (1994) Intestinal drug transport: a surgical problem? Helv Chir Acta 60:935–938

    CAS  PubMed  Google Scholar 

  16. 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):111–116

    CAS  PubMed  Google Scholar 

  17. Schaper A, Hofmann R, Ebbecke M, Desel H, Langer C (2003) Cocaine-body-packing. Infrequent indication for laparotomy. Chirurg 74(7):626–631

    Article  CAS  PubMed  Google Scholar 

  18. Aldrighetti L, Graci C, Paganelli M, Vercesi M et al (1993) Intestinal occlusion in cocaine-packet ingestion. Minerva Chir 48:1233–1237

    CAS  PubMed  Google Scholar 

  19. Traub SJ, Hoffman RS, Nelson LS (2003) Body packing—the internal concealment of illicit drugs. N Engl J Med 349(26):2519–2526

    Article  CAS  PubMed  Google Scholar 

Download references

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Authors and Affiliations

  1. GIZ-Nord Poisons Centre, (Giftinformationszentrum-Nord der Länder Bremen, Hamburg, Niedersachsen und Schleswig-Holstein), Zentrum Pharmakologie und Toxikologie, Georg August University, University Hospital, Robert-Koch-Str. 40, 37099, Göttingen, Germany

    Andreas Schaper, Herbert Desel & Martin Ebbecke

  2. Airport Clinic Frankfurt/Main International Airport, Frankfurt, Germany

    Rainer Hofmann

  3. Aéroport Charles de Gaulle, Paris, France

    Philippe Bargain

  4. Department of General Surgery, University Hospital, Goettingen, Germany

    Claus Langer

Authors
  1. Andreas Schaper
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  2. Rainer Hofmann
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  3. Philippe Bargain
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  4. Herbert Desel
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  5. Martin Ebbecke
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  6. Claus Langer
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Corresponding author

Correspondence to Andreas Schaper.

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Schaper, A., Hofmann, R., Bargain, P. et al. Surgical treatment in cocaine body packers and body pushers. Int J Colorectal Dis 22, 1531–1535 (2007). https://doi.org/10.1007/s00384-007-0324-9

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  • DOI: https://doi.org/10.1007/s00384-007-0324-9

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