Radiologic Findings of CT scan in Body Packers

Introduction & Background: Body packers are those people who swallow opiate drug packages for smug-gling purposes. According to a report of forensic medicine journal, one tonne of opiate drugs are annu-ally transported in this way. Ninety percent of all opiate drugs in the prisons are estimated to be smug-gled through swallowing the packages or rectal or vaginal concealment. Plain abdominal x-ray is the usual and widespread technique for the radiologic confirmation of diagnosis. Due to air entrapment be-tween the cover and the materials (opiate drugs), a double condom or double crescent sign confirms the diagnosis. Patients & Methods: A study on 16 patients was con-ducted, in which we used a new pelvic and abdomi-nal CT scanning without contrast to make a diagnosis. They were 15 male and one female patients mostly in their third decade of life. Number of concealed pack-ages ranged from 1 to150 with a total weight of about 1 to 5kgs. One of the patients died because of the complications following package rupture. Results: As the density of opium and heroin is about 140-170, we recommend a CT scan without contrast as the modality of choice for the diagnosis of these foreign body concealments. In this way we can also follow management of the patient regarding complete removal of the packages. Conclusion: In suspicious cases, however, barium en-ema is required increasing the risk of packages rup-ture. Doing a CT scan with contrast also has the shortcoming of under- diagnosis in bowels full of contrast media due to the density of opiate drug packages. So based on our study, the best way for di-agnosing body packing remains a CT scan without contrast.