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Surgery for "body packers"--a 15-year experience.
Daniel Silverberg1, Tehillah Menes, Unsup Kim
1Department of Surgery, Mount Sinai Medical Center, One Gustave L. Levy Place, New York, NY 10029, USA. daniel.silverberg@mssm.edu
World Journal of Surgery
|March 29, 2006
Summary
Surgical intervention for body packing is rare. Minimizing enterotomies during packet retrieval reduces postoperative wound infections, a common complication in these drug smuggling patients.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Toxicology
Background:
- Body packing of illegal drugs has increased, necessitating surgical intervention.
- Limited established guidelines exist for surgical management of body packers.
- This study reviews surgical treatment characteristics and outcomes.
Purpose of the Study:
- To examine the characteristics and outcomes of patients requiring surgical intervention for body packing.
- To identify key indications, methods, and complications associated with surgical management.
Main Methods:
- Retrospective chart review of patients undergoing surgery for ingested drug packets (1990-2005).
- Inclusion criteria: patients identified via prospective lists and admission codes.
- Data collected: presentation, diagnosis, surgical indications, procedures, and outcomes.
Main Results:
- Twenty-five patients underwent surgery for body packing.
- Primary indications: drug toxicity and small bowel obstruction.
- High postoperative wound infection rate (40%), significantly correlated with the number of enterotomies.
Conclusions:
- Surgical intervention is required for a minority of body packing cases.
- Minimizing enterotomies is crucial to reduce wound infection risk.
- Consideration of delayed wound closure for multiple enterotomies is recommended.