JRSM > Volume 96, Number 6 > Pp. 315

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Cocaine by internal mail

John Bycroft

Institute of Urology & Nephrology, 48 Riding House Street, London W1W 7EY, UK

Mr Swan and his co-authors describe two ‘body packer’ cases (April 2003 JRSM¹) that required surgical intervention. In their closing statement they say that drugs packages are invariably radio-opaque, and this is incorrect. Although the majority of packages may be visualized with plain abdominal radiographs, there are numerous reports of ‘false-negative’ radiographs and subsequently missed packages. ^2,3,4 In equivocal cases the use of CT, ultrasound or contrast meals should be considered; plain radiographs should not be relied on entirely. Doctors dealing with potential body packers should also be aware of disturbing reports from the United States of children acting as surgical mules. ⁵ The diagnosis must therefore be considered within the paediatric population as well.

REFERENCES

1. Swan MC, Byrom R, Nicolaou M, Paes T. Cocaine by internal mail: two surgical cases. J R Soc Med2003; 96:188 -9[Free Full Text]

2. Caruana DS, Weinbach B, Goerg D, Gardner LB. Cocaine-packet ingestion. Diagnosis, management, and natural history. Ann Intern Med 1984;100:73 -4

3. Gherardi R, Marc B, Alberti X, Baud F, Diamant-Berger O. A cocaine body packer with normal abdominal plain radiograms. Value of drug detection in urine and contrast study of the bowel. Am J Forens Med Pathol 1990;11:154 -7[Medline]

4. McCarron MM, Wood JD. The cocaine ‘body packer’ syndrome. Diagnosis and treatment. JAMA1983; 250:1417 -20[Abstract/Free Full Text]

5. Traub SJ, Kohn GL, Hoffman RS, Nelson LS. Pediatric ‘body packing’. Arch Pediatr Adolesc Med2003; 157:174 -7[Abstract/Free Full Text]

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This Article Full Text (PDF) Send a Quick Comment Alert me when this article is cited Alert me when Quick Comments are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Bycroft, J. Search for Related Content PubMed PubMed Citation Social Bookmarking                      What's this?