Hantson P, Capron A, Maillart J-F
Department of Intensive Care, Cliniques St-Luc, Université catholique de Louvain, Brussels, Belgium; Louvain Centre for Toxicology and Applied Pharmacology, Cliniques St-Luc, Université catholique de Louvain, Brussels, Belgium.
Louvain Centre for Toxicology and Applied Pharmacology, Cliniques St-Luc, Université catholique de Louvain, Brussels, Belgium.
J Forensic Leg Med. 2014 Oct;27:62-4. doi: 10.1016/j.jflm.2014.08.013. Epub 2014 Aug 29.
While the management of asymptomatic body packers is mainly conservative, few individuals will require surgery for acute toxicity related to packets rupture, intestinal obstruction or very slow progression of the packages. Obstruction of the lower oesophagus or stomach is not frequently reported. We report the case of a 49-year-old woman who had ingested 92 cocaine-containing packages. She was admitted to the hospital after opioid syndrome related to the intake of morphine and codeine to decrease intestinal transit. The presence of more than 80 packages was suspected in the stomach on the initial abdomen computed tomography. Due to the absence of progression of the packages after four days of well-conducted laxative therapy and to major gastric distension at abdomen tomography, surgery was decided and gastrotomy allowed the evacuation of 80 packages that were still present in the stomach or in the lower oesophagus. In addition, 12 other packages had been retrieved either after laxative therapy (9) or by evacuation via the anal canal (3) after palpation of the intestine during the surgical procedure. No complication was observed.
虽然无症状体内藏毒者的管理主要是保守治疗，但很少有人会因包裹破裂、肠梗阻或包裹进展非常缓慢而导致急性中毒需要手术治疗。下食管或胃梗阻的报道并不常见。我们报告一例49岁女性，她摄入了92个含可卡因的包裹。因服用吗啡和可待因以减缓肠道蠕动后出现阿片类综合征，她被收治入院。初次腹部计算机断层扫描怀疑胃内有80多个包裹。由于在进行了四天的有效泻药治疗后包裹没有进展，且腹部断层扫描显示胃严重扩张，于是决定进行手术，剖腹探查术使仍留在胃或下食管中的80个包裹得以排出。此外，在泻药治疗后找回了9个包裹，手术过程中通过触诊肠道后经肛管排出了3个包裹。未观察到并发症。
