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[Intestinal occlusion in cocaine-packet ingestion]
L Aldrighetti1, C Graci, M Paganelli
1Clinica Chirurgica Generale, IRCCS Ospedale San Raffaele, Università degli Studi di Milano.
Minerva Chirurgica
|October 31, 1993
Summary
Body packers ingest cocaine packets, risking bowel obstruction and acute cocaine intoxication. Conservative management is standard, but emergency surgery is vital for complications like ileus due to packet clustering.
Area of Science:
- Medical Science
- Toxicology
- Emergency Medicine
Background:
- Drug trafficking and customs enforcement drive innovative smuggling methods.
- Body packers ingest drug-filled packets, often with anticholinergics, to evade detection.
- Conservative management of spontaneous packet evacuation is the current approach.
Observation:
- A 19-year-old asymptomatic body packer presented for conservative management.
- During spontaneous evacuation, the patient developed clinical and radiological signs of bowel obstruction.
- Emergency laparotomy revealed 21 ingested cocaine packets, with two clustered in the distal ileum causing occlusion.
Findings:
- Cocaine packet ingestion can lead to severe bowel obstruction.
- Packet clustering in the ileum is a critical cause of obstruction in body packers.
- Acute cocaine intoxication from transmucous absorption poses a lethal risk due to lack of specific antidotes.
Implications:
- Bowel obstruction in body packers requires prompt surgical consideration.
- The high mortality rate (56%) underscores the urgency of managing cocaine packet ingestion complications.
- Lack of a specific antidote for cocaine poisoning highlights the critical need for rapid intervention.