Abstract:
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Purpose: To measure the accuracy of ultrasound, plain x-ray abdomen and CT scan in the detection of drug capsules in body packers.
Methods and Materials: Between January 1999 and February 2003, 389 cases of body packers (swallowers & stuffers) were brought to JPMC by different law enforcement agencies. The patients were admitted in the National Poison Control Centre of JPMC and were referred to the Department of Radiology, JPMC for detection of the drug capsules. Out of 389 patients, only 70 were enrolled for this comparative study. All of these patients were exposed to all the three modalities. US were performed on Ecoccee power Color Doppler; X-rays on Trophy 500ma unit and CT scan on spiral CT scan XpressGX. No special bowel preparations were given, including purgatives, because of the risk of rupture of the capsules.
Results: Among the 70 patients male to female ratio was 50:20. Their ages ranged between 20 and 40 years, mostly in the 3rd decade of life. They belonged to 18 different countries. All of them had a drug (heroin) packed in latex material of varying sizes, measuring 3-10 cm, concealed in the GIT. Five females also had capsules in their vaginal canal. On sonography rounded to oval shaped echogenic foci with posterior acoustic shadowing were found only in 49 patients (70%). Plain x-ray abdomen revealed round to oval or rectangular shaped foreign bodies surrounded by gas halos, diagnosed only in 59 patients (85%). CT scan (scout film) revealed these capsules as foreign bodies in all the 70 patients (100%). The average number of capsules recovered from these patients ranged between 50-110 and the amount of heroin varied from 600 to 1100 gms.
Conclusion: A radiologist should be familiar with the appearance of drug capsules on all modalities, although the CT scout film proved to be the best modality for the detection of heroin capsules in body packers.
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Mahmood MBBS, T,
Drug Smuggling by Body Packers: Comparative Study of Ultrasound, X-ray, and CT Scan in Detection of Heroin Capsules. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3104184.html
