Radiographic evaluation of the cocaine smuggler

A retrospective analysis of the plain abdominal films of 53 "body packer" drug smugglers was performed to ascertain the importance of radiographic studies in the diagnosis and management of these patients. Eighty-nine percent had studies diagnostic for foreign body ingestion. Multiple, well-defined, homogeneous oval or oblong densities, especially if surrounded by a crescent of air (double-condom sign), are key findings. If these densities were found in the proximal ascending colon or upper gastrointestinal tract, the diagnosis was almost assured. Six percent of patients exhibited complications suggested on serial radiographs, proving the necessity for follow-up studies until complete expulsion or removal of the foreign body. Radiologic evaluation is essential in the diagnosis and management of the cocaine smuggler.