The body packer syndrome: a case report and review of the literature

BACKGROUND: Ingestion of illicit drug packages is a well known method for t ransportation. These packages are prone to rupture causing overdose. The bo dy packer syndrome may be overlooked in medical practice as illustrated by the following case report. CASE REPORT: A 19-year old male had convulsions followed by cardiac arrest during a flight. He was resuscitated in the plane, but he died a few hours after admission in intensive care unit. Chest and abdominal X-rays were con sidered normal. Cocaine metabolites were found in his urine. The death was considered suspicious. X-rays performed before medicolegal autopsy showed n umerous packages in his digestive tract. Thirty-six packages were found in the stomach and intestine. Two were ruptured in the stomach. The cause of d eath was cocaine overdose caused by package rupture. DISCUSSION: The packages are usually visible on an standard abdomen Xray. T he drug is often wrapped in latex membranes or condoms. The air is trapped between the condoms by the nodes, forming two crescents visible on the X-ra y. Surgery is preferred to laxatives when the packages are fragile with a h igh risk of rupture. (C) 2001, Masson, Paris.