Elsevier

Legal Medicine

Volume 31, March 2018, Pages 10-13
Legal Medicine

Case Report
Body packing and intra-vaginal body pushing of cocaine: A case report

https://doi.org/10.1016/j.legalmed.2017.12.004Get rights and content

Highlights

  • Body pushers smuggle illicit drugs by inserting them into rectum or vagina.

  • A typical body-stuffer will be male in 3rd or 4th decade.

  • Rupture of vaginal drug packet may cause systemic absorption and death.

  • Ear, nose and throat are also potential sites for body stuffing.

  • CT scan is useful diagnostic technique in suspected body packers.

Abstract

Drug trafficking is an international problem. The prevalence of drug trafficking and newer concealing methods has been ever increasing. Body packing is described as using the abdominal or pelvic cavity for concealing illegal drugs. Body pushers smuggle illicit drugs by inserting them into rectum or vagina. These cases are either presented to the emergency departments as Body Packer Syndrome or as asymptomatic cases for observation, detained for alleged possession of contraband substances. We report a unique case of an asymptomatic white female who was detained at Mumbai International Airport under suspicion and brought to hospital for observation. X ray and CT scan examination revealed 7 wrapped packets in gastrointestinal track and 1 large packet in vagina. A case of female body packer using multiple modalities of concealment especially in vagina is rare in India so it is becomes imperative to present this case in the light of body packing and body pushing of contraband substances.

Introduction

Body packing was first reported in 1973 by Deitel and Syed [1], who described a 21-year-old patient who had developed small bowel obstruction after swallowing a condom filled with hashish. Currently, the word “body packer” is generally used to define a drug carrier who swallows packages of illicit drugs to hide them in his/her alimentary tract. These criminals carry several names: “body packers”, “couriers”, “swallowers”, “internal carriers” or “mules” [2]. Body packers commonly ingest large bags (2–8 cm) [3] containing drugs prior to crossing international borders, to recover them after arrival at their destination. Their drug bags are carefully packed and enveloped in containers expected to remain undamaged during the gastrointestinal tract transit. To increase clarity, two other terms have been used: “body pusher” and “body stuffer”. The “body pusher” introduces the drug packages rectally or vaginally; these packages are commonly bigger than those swallowed [4]. The “body stuffer”, also called “mini packer”, is an individual (usually a trafficker or user) who ingests small amounts of loosely wrapped narcotics, plastic pouches or small pellets upon an accidental encounter with law enforcement for fear of arrest [4].

Smugglers present to hospital either after detection by customs, or following the development of symptoms and signs of ingested drug toxicity or intestinal obstruction [5]. Currently available data suggest that careful monitoring of the body packers for possible signs and symptoms of drug toxicity and bowel obstruction is critically important [6]. Detection of body packing is an important task for the emergency physicians because it requires immediate medico-legal attention and is potentially fatal as the packages may rupture, releasing lethal doses of drug into the body [7].

This report thus describes the management of medico-legal case of an asymptomatic white female who has swallowed cocaine filled packages and inserted one large packet into vagina. Repeat CT examination was done to rule out any retained foreign body before discharging and handing over the patient to narcotics department.

Section snippets

Case report

A 36 year old white female was brought by police to hospital with alleged history of possession of contraband substances. She was arrested from Mumbai International Airport. On initial screening and complete background check of investigating agency it was found that she had a rough childhood with poor socioeconomic condition due to which she was forced into prostitution. She is a single mother trying to make both end meet during which she was approached by a mutual friend, a known drug peddler

Discussion

Body packers are often suspected because of unusual behaviours, such as using specific travel routes, sitting motionless, refusing to eat or drink during the flight, and a typical breath odour resulting from gastric acid acting on the capsules [8]. Drugs are usually packed tightly and wrapped into a sheath like finger of latex gloves, plastic bags, condom, aluminium foil or balloon [9], [10]. Body packers usually use constipating agents, especially diphenoxylate or loperamide, after swallowing

Conclusion

Even though rare, females have been used as mules for smuggling of drugs. Law enforcement agencies should be aware of the fact that apart from gastro-intestinal track other potential spaces like vagina in female, urethra and glans penis in male, nasal cavity, ear and oral cavity should be thoroughly examined during physical examination for any concealed substances. Whether asymptomatic or symptomatic, suspects should always be immediately referred to Emergency Department for medical

Conflict of interest

No conflict of interest.

Source of support

Not applicable.

Ethical clearance

Not required.

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