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Case Report
Surgical decontamination in heroin body packer, Asharqia, Egypt: Case report
1 Forensic Medicine and Clinical Toxicology and General Surgery, Department Faculty of Medicine, Zagazig University, Egypt
2 Department Faculty of Medicine, Zagazig University, Egypt
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Dalia M. Amin
Clinical toxicology Departments Faculty of Medicine, Zagazig University,
Egypt
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Article ID: 100007Z95DA2019
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Amin DM, El Teliti AM. Surgical decontamination in heroin body packer, Asharqia, Egypt: Case report. Edorium Open 2019;2:100007Z95DA2019.ABSTRACT
Introduction: Intra-corporeal concealment of recreational drugs known as ‘body packing’ is uncommonly reported. Opium, heroin, and marijuana are the most incorporated drugs. Body packers may also be called swallowers, internal carriers, couriers or mules. Gastrointestinal obstruction or toxicity of the leaking drugs inside the packets are the main symptoms appear. Management strategies are determined by the sypmptoms of presentation. Gastrointestinal decontamination as well as surgical decontamination may be indicated.
Case Report: A 35-year-old confirmed body packer was brought to our emergency department from the prison because of repeated vomiting and abdominal pain. He presented with a high respiratory rate of 40/min but normal oxygen saturation on ambient air, a heart rate of 110 bpm, a blood pressure of 110/70 mmHg and a temperature of 38.0° Celsius. Blood tests were suggestive of infection with electrolytes imbalance, urine analysis was positive for morphine and Tramadol. Abdominal and thoracic X-rays showed pulmonary infiltrates as a possible focus of infection; no signs of bowel obstruction or perforation. Given his history of ingestion of foreign body and his clinical presentation, we suspected acute abdomen to be the main problem. We therefore did immediate surgical decontamination with extraction and primary repair of gastric incision.
Conclusion: This case illustrates the challenges to diagnose, evaluate the potential drug packers and to consider body packer in acute abdomen and intestinal obstruction cases in emergency department for early surgical decontamination before acute toxicity of large overdose and probably death.
Keywords: Body packer, Egypt, Heroin, Surgical decontamination
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Author Contributions
Dalia M. Amin - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Ahmed M. El Teliti - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Source Of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this case report.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2019 Dalia M. Amin et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
