Abdominal X-ray signs of intra-intestinal drug smuggling

被引:32
作者
Niewiarowski, Sylwia [1 ,2 ]
Gogbashian, Andrew [1 ,2 ]
Afaq, Asim [1 ,2 ]
Kantor, Robin [2 ]
Win, Zarni [1 ,2 ]
机构
[1] Hammersmith Hosp, Imperial Coll Healthcare NHS Trust, London W12 0HS, England
[2] Hillingdon Hosp, London UB8 3NN, England
关键词
Body packer; Drug smuggling; Intra-luminal; Intra-intestinal; Abdominal X-ray; Signs; BODY-PACKER SYNDROME; COCAINE; DIAGNOSIS;
D O I
10.1016/j.jflm.2009.12.013
中图分类号
DF [法律]; D9 [法律]; R [医药、卫生];
学科分类号
030101 [法学理论]; 030111 [法律史学]; 100218 [急诊医学];
摘要
Introduction: "Body packers" either swallow or insert drug filled packets rectally or vaginally in order to smuggle illicit drugs. AXR is used routinely to screen suspects for the presence of intra-intestinal drug packages. AXR diagnosis can be difficult as stool or gas within the intestine may resemble ingested foreign bodies. We identify the frequency and co-existence of several signs; tic-tac sign, rosette sign, double condom sign, dense surrounding material, density and discover a new sign; parallelism, which will aid in increasing the radiological accuracy. Methods: We retrospectively reviewed 285 AXRs performed for suspicion of drug smuggling during the period of March 2006-March 2009 to identify the frequency of these signs. Results: Of the 285 AXRs performed 59 were positive, 221 negative and five were indeterminate. The tictac sign was present in 93%, double condom sign in 73%, dense surrounding wrapping material in 36% and parallelism in 27%. Sixty one percentage of drug packages were iso-dense to faeces and 39% hyperdense. Twenty percentage of the positive abdominal radiographs demonstrated one of the radiographic signs, 39% demonstrated two signs, 32% demonstrated three and 7% four. The most common radiographic sign combination was the tic-tac sign with either dense surrounding material or double condom sign. Conclusion: The most commonly encountered radiographic sign is the tic-tac sign, followed by the double condom sign and dense surrounding material. We also discover a new sign, "parallelism" which although uncommon is highly specific. Accuracy is further increased by comparing the density of packages to faeces and looking for the co-existence of multiple signs. (C) 2010 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
引用
收藏
页码:198 / 202
页数:5
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