Best paper yet on screening suspected body packers

December 2, 2014, 10:33 pm

Body packer

Body packer

★★★★½

Body packing: a review of general background, clinical and imaging aspects. Bert FH et al. Radiol Med 2014 Oct 10 [Epub ahead of print]

Abstract

I’d say this is the best article on imaging suspected body packers we’re likely to see, but with the rapid evolution of radiological technology it will likely need to be updated every year or so. Nevertheless, it is the best review of the topic available, and has spectacular illustrations.

The five authors rely on their experience as radiologists in major European cities, as well as published medical  literature, to review test characteristics of various imaging modalities in detecting body packers as well as body pushers (smugglers who insert large drug packets into the rectum or vagina in an attempt to transport them surreptitiously.) The drug packets usually contain cocaine or heroin.

Some key points made in the paper:

  • Plain abdominal x-rays are relatively insensitive in detecting ingested drug packets, especially when fewer than a dozen are present (sensitivity 40-90% in various studies.)
  • Oral contrast does not increase sensitivity of the plain abdominal film.
  • Computed tomography is highly sensitive in detecting the presence of ingested drug packets (95 – 100%.)
  • Most current screening protocols published in the medical literature call for an abdominal and pelvic CT scan without oral or intravenous contrast.
  • As technology improves,  CT scanning is able to provide reliable screening information using radiation doses that are reduced an order of magnitude compared to those previously required.
  • The use of MRI for screening suspected drug packers or pushers is not yet ready for prime time.

This paper has many interesting x-ray, CT, and ultrasound images, as well as 30 references — some as recent as this year. Highly recommended.
Related posts:

Conservative treatment of asymptomatic body packers?

Body packers: can CT determine the number of drug packets?

MRI for body packers?

Low-dose abdominal CT is superior to plain film for imaging suspected body packers

Cannabis body packers

Treatment protocol for symptomatic body packers (mules)

Cocaine mules: what to do with body packers
[Note: photograph of body packer is not from the paper discussed in this post]

 

 

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