Clinical Management of Body Packing Incidents

Body packing describes the internal concealment of illicit or non-narcotic items, most commonly within the gastrointestinal tract, for the purpose of smuggling. Clinical management begins with prompt recognition in asymptomatic individuals under law-enforcement supervision or in those presenting with non-specific complaints such as abdominal pain, nausea or altered mental state. Initial assessment hinges on focused history and physical examination, though packers seldom volunteer ingestion details. Imaging—principally low-dose unenhanced CT—has become the mainstay for detecting retained packets and determining their number, size and anatomical location. Conservative management, including whole-bowel irrigation and close monitoring on a high-dependency unit, is indicated for stable patients whose packets are progressing through the bowel. Surgical intervention is reserved for complications such as intestinal obstruction, packet rupture with toxicity or failure of conservative measures. Emerging alternatives such as endoscopic retrieval have shown promise in selected cases, offering a minimally invasive option when packets stall in the upper gastrointestinal tract. Multidisciplinary coordination among emergency physicians, radiologists, gastroenterologists and surgeons is critical to optimise outcomes. Globally, the rise of more sophisticated packet materials and non-drug contents underscores the need for adaptable protocols and heightened clinical vigilance.

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Clinical Management of Body Packing Incidents publication trend

The graph below shows the total number of articles in clinical management of body packing incidents across all publications each year (not limited to Nature Index journals).

Technical terms

Body packing: Deliberate ingestion or insertion of sealed packets containing illicit substances or other items into body cavities for smuggling.
Body stuffing: Rapid or impulsive ingestion of loosely wrapped drugs to evade immediate detection, often with higher risk of packet rupture and toxicity.
Whole-bowel irrigation: Administration of large volumes of osmotically balanced solution to expedite passage of ingested packets through the gastrointestinal tract.
Endoscopic retrieval: Use of a flexible endoscope and retrieval devices to remove packets lodged in the oesophagus, stomach or proximal small bowel.
Computed tomography (CT): Imaging modality that provides high-resolution detection of foreign bodies without contrast, minimising diagnostic uncertainty.

References

1. Emergency department management of body packers and body stuffers. Swiss Medical Weekly (2017).
2. Clinical, Diagnostic, and Treatment Features of Body Packing in Brazil: Drugs, Cell Phones, and Beyond. Cureus (2022).
3. A Case of Cocaine Toxicity From Body Stuffing. Cureus (2023).
4. Endoscopic Management of Ingested Narcotic Substances: A Case Report and Literature Review. Cureus (2022).
5. Body Pushers: Low-Dose CT, Always the Best Choice? A Study of the Diagnostic Performance of CT Scout View. Open Journal of Radiology (2017).