Presentation
Brought in by Customs & Border Protection. Suspected "body packing"
Patient Data
Non-contrast imaging has been obtained as per protocol. Approximately 73 near identical ovoid dense foreign bodies are demonstrated predominantly within the large bowel and rectum, interspersed with fecal matter. These individually measure approximately 3-4 cm in size. Aside from the large bowel and rectum, there is one observed within the gastric antrum, and a few within the small bowel/terminal ileum. There is no free fluid or free gas. No abnormal bowel dilatation to suggest obstruction. Within the limitations of a non-contrast study, the remainder of the imaged abdominal viscera appear normal. No lymphadenopathy. No suspicious osseous lesions. Imaged lung bases are clear.
Conclusion: Numerous presumed ingested intra-abdominal foreign bodies identified. Given the clinical presentation, appearances are highly suggestive of packaged substances. Clinical correlation is recommended.
Emergency physician and the attending Federal Officers have been informed of findings.
Case Discussion
The number of individual packs were determined on CT so that Customs and Border Protection Officers can correlate with their count of excreted or retrieved packs.
Apart from detection of the presence of packs, the radiologist's role is to look for complications such as bowel perforation. A broken pack is usually evident clinically (unconsciousness in case of heroin, tachycardia etc. in case of cocaine).