Department of Surgery, Caritas Health Care, New York Medical College-Brooklyn and Queens Program, New York, USA.
Emerg Med J. 2011 Feb;28(2):98-101. doi: 10.1136/emj.2008.059717. Epub 2010 Nov 10.
'Mules' or body packers are people who transport illegal drugs by packet ingestion into the gastrointestinal tract. These people are otherwise healthy and their management should maintain minimal morbidity. In this study, experience with body packers is presented and an algorithm for conservative and surgical management is provided.
The clinical patient database for all body packer admissions at Mary Immaculate Hospital of the Caritas Health Care Inc. from 1993 to 2005 was interrogated. 56 patients (4.5%) required admission out of a total of 1250 subjects confirmed to be body packers and apprehended by United State Customs officials at JFK International Airport, New York. The retrieved patient data were analysed retrospectively.
70% of the body packers were men, with a male to female ratio of 2.8 to 1. The mean age was 33 years and 52% were from Columbia. Heroin was the most common illegally transported substance (73%). 25 patients (45%) required surgical intervention, whereas 31 patients (55%) were successfully managed conservatively. Indications for intervention included: bowel obstruction, packet rupture/toxicity, and delayed progression of packet transit on conservative management. Multiple intraoperative manoeuvres were used to remove the foreign bodies: gastrotomy, enterotomy and colotomy. Wound infection was the most common complication and is associated with distal enterotomy and colotomy.
Men were more likely to present as body packers than women. Proximal enterotomies are preferred and multiple enterotomies should be avoided. A confirmatory radiological study is needed to demonstrate complete clearance of packets. A systematic protocol for the management of body packers results in minimal morbidity and no mortality.
“骡子”或体包藏者是通过将非法药物包裹在肠胃道中进行包裹摄入来运输毒品的人。这些人通常身体健康，他们的管理应尽量减少发病率。在这项研究中，介绍了体包藏者的经验，并提供了保守和手术管理的算法。
检索了 1993 年至 2005 年期间，嘉爱护理医疗公司玛丽安杰利医院所有体包藏者入院的临床患者数据库。在纽约肯尼迪国际机场被美国海关官员确认并逮捕的 1250 名体包藏者中，有 56 名（4.5%）需要入院。回顾性分析了检索到的患者数据。
70%的体包藏者为男性，男女比例为 2.8 比 1。平均年龄为 33 岁，52%来自哥伦比亚。海洛因是最常见的非法运输物质（73%）。25 名患者（45%）需要手术干预，而 31 名患者（55%）成功保守治疗。干预的指征包括：肠梗阻、包裹破裂/毒性、以及在保守治疗下包裹转运的延迟进展。术中使用了多种操作来移除异物：胃切开术、肠切开术和结肠切开术。伤口感染是最常见的并发症，与远端肠切开术和结肠切开术有关。
男性比女性更有可能成为体包藏者。首选近端肠切开术，应避免多次肠切开术。需要进行确认性放射学研究以证明包裹完全清除。体包藏者的管理系统方案可导致发病率最低，无死亡率。
