Due to a recent trauma to his left wrist, he was accompanied to our University Hospital for an X-ray. Once in Radiology, he confessed to the technician that he had ingested an illicit drug packet 4 days earlier in anticipation of an impending cell search.
The drug packet was reportedly 4 to 5 cm in size, contained 6 to 8 g of cocaine, and was wrapped in a condom and plastic food-wrap. He was worried because he had not yet evacuated the packet and had been experiencing mild epigastric pain for a few hours before his x-ray appointment. He did not have any other gastrointestinal (GI) symptoms, including nausea, vomiting, diarrhea, and constipation. After the wrist X-ray he was taken to our Emergency Department (ED) for the management of the body stuffing.
On admission, his vital signs were as follows: blood pressure of 131/60 mmHg, heart rate of 74 beats/minute, and temperature of 37.6 °C. He was alert, oriented, calm, and expressed no intention of self-harm. A physical examination revealed epigastric tenderness, but no abdominal rigidity, guarding, rebound tenderness, or evidence of a palpable mass. The rest of the examination was unremarkable, including a cardiopulmonary and a complete neurological examination.
Laboratory findings were within normal range, including a complete blood count (hemoglobin of 16.2 g/dL, white cell count of 8.5 G/L, platelet count of 121 G/L), kidney and liver function tests, and a urine analysis. Tests for HIV and hepatitis B were negative.
He returned to our Radiology Department where a low-dose abdominal CT scan was performed and revealed multiple foreign bodies of similar aspect throughout his stomach, his duodenum, and his small intestine, all of which were consistent with packets of loosely aggregated drugs. There was no sign of GI perforation or obstruction.