Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Clinical Toxicology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Arh Hig Rada Toksikol. 2019 Jun 1;70(2):90-96. doi: 10.2478/aiht-2019-70-3199.
Managing body packers and stuffers is a challenge to emergency physicians, stuffers in particular, as there is no systematic approach to their treatment. The aim of this study was therefore to review all available literature on body stuffing and propose a guide to manage these patients. We searched Medline/PubMed, Google Scholar, and Scopus for published work on body stuffers using key words "body stuffer", "body stuffing", "poisoning", "toxicity", and "treatment" without a time limit and retrieved 290 articles, of which 61 remained after exclusion of those on "body packers" and repetitive documents. This review article evaluates and summarises the information gathered from them. The main step in body stuffer management is observation to make sure that they have passed all the swallowed packages of drugs of abuse. In some cases, imaging can be quite useful. Diagnostic pitfalls may be avoided with abdominopelvic CT without contrast, which is probably the best diagnostic method to determine the presence and the number of packages in these patients. Treatment should be specific for each group of drugs, whether it is opioids, cocaine, or amphetamine. Surgical interventions are indicated for obstruction of the intestines or package rupture. Legal precautions should be taken because of the legal complexity of body stuffing cases.
处理体内藏毒者和藏毒是急诊医师面临的挑战，尤其是藏毒者，因为目前还没有针对他们的治疗方法。因此，本研究旨在回顾所有关于体内藏毒的可用文献，并提出管理这些患者的指南。我们使用关键词“藏毒者”、“体内藏毒”、“中毒”、“毒性”和“治疗”，在 Medline/PubMed、Google Scholar 和 Scopus 上搜索了关于体内藏毒者的已发表文献，没有时间限制，并检索到 290 篇文章，排除了关于“藏毒者”和重复文献后，有 61 篇文章保留下来。这篇综述文章评估并总结了从这些文章中收集到的信息。管理体内藏毒者的主要步骤是观察，以确保他们已经排出了所有吞下的毒品包裹。在某些情况下，影像学检查可能会很有用。通过无需造影的腹部盆腔 CT 可以避免诊断陷阱，这可能是确定这些患者包裹存在和数量的最佳诊断方法。治疗应针对每个药物组，无论是阿片类药物、可卡因还是安非他命。如果出现肠道阻塞或包裹破裂，则需要手术干预。由于体内藏毒案件的法律复杂性，应采取法律预防措施。
