CT Scans best to uncover body packed drugs..

CT SCANS BEST TO UNCOVER BODY PACKED DRUGS….

During 1924, Captain T W Barnard, Director, Erstwhile Institute of Radiology at the General Hospital, Madras has helped the police to locate the gold chain in the stomach of a thief by x-ray techniques. Similar many robbers and smugglers have been caught re handed by this way.

Body Packing:
        The US customs and Border Patrol (CBP) seize over a million pounds of drugs (mainly marijuana, cocaine, heroin and several other hallucinating drugs) annually.
Eighty percent of the smugglers are caught by ‘body packing’ of these illegal narcotics.
According to the May 2008 issue of Applied Radiology describes the practice of body packing as the trafficking of illicit drugs within the vagina or the gastrointestinal tract. These body packers are also known as ‘Swallowers’, ‘Internal Carriers’, ‘Couriers’ or ‘Mules’. The most commonly used term is Mules……….……

Definition of Body packing:
        A method for smuggling narcotics in which a ‘courier’ swallows condoms or other containers filled with pure cocaine or heroin to escape detection by customs agents and specially trained dogs; the body packer ‘syndrome’ consists of a constellation of medical complaints—e.g., intestinal obstruction and rupture of bags, which, without immediate medical care, can be rapidly fatal.
Kinder Surprise and Easter egg are both slang terms for drug mules.
The drugs may be placed in condoms or in packets enclosed by several layers of polyethylene or latex and sometimes covered with an outer layer of wax. After body packers (“mules”) swallow multiple packets, they typically take antimotility drugs to decrease intestinal motility until the packets can be retrieved. Rupture of one or more packets is a risk, resulting in abrupt toxicity and overdose. Specific symptoms depend on the drug, but intractable seizures, tachycardia, hypertension, and hyperthermia are common with cocaine, and coma and respiratory depression are common with heroin. Intestinal obstruction or rupture and peritonitis are also risks.
Body stuffing is similar to body packing; it occurs when people about to be apprehended by law enforcement swallow drug packets to avoid detection.


Diagnosis
Suspected body packers are usually brought to medical attention by law enforcement officials, but clinicians should consider body packing if recent travelers and newly incarcerated people present with coma or seizures of unknown etiology. Body packing can sometimes be confirmed when packets are detected during rectal examination. Plain x-rays can often confirm the presence of packets in the GI tract.

False negatives:
        Writings in The New England Journal of Medicine, instances showed that using plain abdominal x-rays can detect the drugs in the mules.


        According to the researchers, cocaine containers, which may be swallowed or inserted in the vagina or rectum, can be large as a banana or as small as a blueberry.

Treatment:
Treatment of patients with symptoms of overdose (and presumed packet rupture) is supportive and includes airway protection, respiratory and circulatory support, and anticonvulsants, depending on patient symptoms. Sometimes, specific antidotes are indicated (see under specific drugs). Usually, unruptured packets can be removed by whole-bowel irrigation. However, once packets rupture, immediate surgical or endoscopic removal (depending on location in the GI tract) of all packets is indicated but can rarely be done in time; death commonly occurs because the quantity of drug released is large. Patients with intestinal obstruction or perforation also need immediate surgery. Activated charcoal may be helpful but is contraindicated in patients with obstruction or perforation.
Asymptomatic body packers should be observed for development of symptoms until the packets are passed and followed by several packet-free stools. Some clinicians use whole-bowel irrigation with a polyethylene glycol solution with or without metoclopramide as a promotility agent.



Higher dosage:
        CT exposes the suspects to higher doses of ionizing radiation. It is obviously of concern while imaging healthy people. Low dose protocols need to be implemented to ensure the safety of the people undergoing this procedure.

 

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