[Cocaine-body-packing. Infrequent indication for laparotomy].

Area of Science:

• Forensic Toxicology
• Emergency Medicine
• Public Health

Background:

• Body packers, or "mules," smuggle cocaine by swallowing condoms, posing significant health risks.
• Body pushers conceal drugs internally (rectum/vagina), presenting distinct challenges.
• This study addresses the critical issue of ruptured cocaine-filled condoms in body packers.

Purpose of the Study:

• To analyze data on body packers and body pushers identified at Frankfurt Airport.
• To develop an effective management algorithm for ruptured cocaine-filled condoms.
• To investigate temporal trends, demographics, and surgical outcomes.

Main Methods:

• Retrospective analysis of data from 1985 to 2001.
• Inclusion of all identified cocaine body packers and body pushers.
• Focus on symptomatic cases, surgical interventions, and mortality.

Main Results:

• 2880 body packers and 280 body pushers identified between 1985-2001.
• 63 body packers (2.2%) experienced severe cocaine intoxication due to condom rupture.
• Emergency laparotomy in 20 symptomatic patients resulted in survival; 43 died before surgery.

Conclusions:

• Rupture of cocaine-filled condoms leads to life-threatening intoxication.
• Generalized vasoconstriction is a primary cause of mortality.
• Immediate laparotomy for condom removal is the only effective therapy.