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- W3204932805 abstract "A 28-year-old woman was brought into the emergency department (ED) for unresponsiveness after she had suffered an apparent seizure at a party. She was noted to have pinpoint pupils and received 2 mg of intramuscular naloxone in the field, without an immediate response. In the ED, the patient had a blood pressure of 153/83 mm Hg, a pulse rate of 147 beats/min, and an O2 saturation of 84% on room air. She was lethargic but had no focal neurological deficits. Her urine toxicology screen was negative for benzodiazepines, barbiturates, cocaine, opiates, and methadone. Her chest radiograph showed clear lungs (Figure 1). Given her initial hypoxia and persistent tachycardia, she underwent computed tomographic angiography of the chest (Figures 2 and 3).Figure 2Computed tomography of the abdomen (axial view) showing multiple foreign bodies of various attenuations and sizes in the stomach, with some measuring up to 6.5 cm x 2 cm.View Large Image Figure ViewerDownload Hi-res image Download (PPT)Figure 3Computed tomography of the abdomen (coronal view) demonstrating the foreign bodies located in the patient’s stomach.View Large Image Figure ViewerDownload Hi-res image Download (PPT) Body packing of an illicit substance. The computed tomography scan demonstrated a significantly distended stomach containing multiple well-circumscribed foreign bodies. The patient subsequently admitted to swallowing packets containing an unknown illicit substance. Given her elevated heart rate and blood pressure, there was concern for a ruptured pack containing a sympathomimetic. She was taken emergently to the operating room for an exploratory laparotomy. Fifty pouch-like objects were removed from her stomach and small bowel (Figure 4). The packets contained over one million dollars in street value of M30, a counterfeit version of oxycodone pills that may contain lethal doses of fentanyl.1DEA Reports Significant Increase in Counterfeit Pills in Minnesota. United States Drug Enforcement Administration website.www.dea.gov/press-releases/2020/08/12/dea-reports-significant-increase-counterfeit-pills-minnesotaGoogle Scholar Radiographic imaging is not sensitive for body packing, with reported sensitivities as low as 28% to 35%. Noncontrast computed tomography imaging is more sensitive (97% to 100%) and is the diagnostic imaging of choice.2Traub S.J. Kohn G.L. Hoffman R.S. et al.Pediatric “body packing”.Arch Pediatr Adolesc Med. 2003; 157: 174-177https://doi.org/10.1001/archpedi.157.2.174Crossref PubMed Scopus (46) Google Scholar,3Rousset P. Chaillot P.F. Audureau E. et al.Detection of residual packets in cocaine body packers: low accuracy of abdominal radiography-a prospective study.Eur Radiol. 2013; 23: 2146-2155https://doi.org/10.1007/s00330-013-2798-xCrossref PubMed Scopus (15) Google Scholar" @default.
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- W3204932805 date "2021-10-01" @default.
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- W3204932805 title "Young Female With Seizure" @default.
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- W3204932805 doi "https://doi.org/10.1016/j.annemergmed.2021.04.010" @default.
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