Summary
Retrospective review of 862 intraabdominal body packers carrying illicit drugs admitted to an emergency department observation unit: the management protocol
Estévez Rueda MJ, Guisado Vasco P, Alba Muñoz L, Carpena Zafrilla M, Gallego Rodríguez P, Trueba Vicente A
Affiliation of the authors
Servicio de Urgencias, Hospital Universitario Ramón y Cajal, Madrid, Spain.
DOI
Quote
Estévez Rueda MJ, Guisado Vasco P, Alba Muñoz L, Carpena Zafrilla M, Gallego Rodríguez P, Trueba Vicente A. Retrospective review of 862 intraabdominal body packers carrying illicit drugs admitted to an emergency department observation unit: the management protocol. Emergencias. 2013;25:451-8
Summary
Objective: To describe the management of illicit drug body packers in the emergency
department of Hospital Universitario Ramón y Cajal in Madrid, the referral hospital for
the Madrid-Barajas airport.
Method: The case histories of body packers admitted from July 2007 to March 2012
were reviewed. In 2011, differences in management were established in relation to
packaginga, reflecting greater theoretical risk of rupture with the use of soft materials or
containers holding drugs in liquid form.
Results: A total of 862 cases were studied. Most body packers were men. The median
age (interquartile range) was 32 (14) years. Most (78.1%) had no history of prior
medical conditions, and 67.8% were not drug users. The body packers had typically
swallowed the containers (in 93.5% of the cases). Cocaine was the drug being
transported in most cases (83.2%). A mean (SD) of 61 (31) packages were being
transported; 83.7% were made of a hard material. Signs of acute drug poisoning were
present in 0.8%. It was possible to discharge 98.5% of the patients after conservative
management. Surgery was performed in 13 cases. Statistically significant variables
related to the need for emergency surgery were symptoms of acute poisoning (P<.001), heart rate (P<.001), white blood cell count with left shift (P=.037), duration of hospitalization (P<.001), and number of package-free bowel movements (P=.002). No deaths occurred; the median duration of hospitalization was 3 (3) days. Medical management was successful before and after the change in protocol (in 98.7% and 96.3% of the body packers, respectively). Conclusions: A high success rate (98.5%), with no deaths, was achieved with the proposed protocol for managing body packers according to type of material used to enclose the drug.