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Asymptomatic body packers should be treated conservatively.

Peter V Glovinski1, Morten L Lauritsen, Morten Bay-Nielsen

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Conservative management is effective for most body packers, avoiding surgery unless complications like obstruction or perforation occur. This approach prioritizes patient safety and avoids unnecessary interventions for drug smuggling cases.

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Area of Science:

  • Gastroenterology
  • Toxicology
  • Forensic Medicine

Background:

  • Body packing, the concealment of drugs within the alimentary tract, poses risks of packet rupture or obstruction.
  • While often asymptomatic, complications necessitate careful management of drug smugglers.
  • Current guidelines suggest preventive surgery for prolonged package retention (5-7 days).

Purpose of the Study:

  • To evaluate a conservative, protocolled approach for managing patients suspected of body packing.
  • To determine the efficacy and safety of non-surgical interventions.

Main Methods:

  • Retrospective analysis of patients suspected of body packing admitted to a surgical gastroenterology department.
  • Study period: March 2011 to February 2013.
  • Confirmation of body packing via CT scan.

Main Results:

  • 57 patients were admitted; body packing confirmed in 29 (53%) via CT.
  • All 29 confirmed body packers were successfully treated conservatively, without surgical or endoscopic intervention.
  • Median ingested packages: 55 (range 2-120); no signs of rupture or emergency operations required.

Conclusions:

  • Conservative management is feasible and effective for body packers without clinical signs of obstruction, perforation, or intoxication.
  • Prolonged package retention alone is not an indication for emergency surgery.
  • This approach can safely manage drug smugglers and prevent complications.