Department of Emergency Medicine, Arrowhead Regional Medical Center, 400 N. Pepper Ave, Colton, CA, 92324, USA.
Department of Probations, San Bernardino County, San Bernardino, CA, 92415, USA.
J Med Case Rep. 2022 Nov 4;16(1):426. doi: 10.1186/s13256-022-03628-9.
Body stuffing and body packing are two methods of concealing illicit drugs. Body stuffing is defined as the oral ingestion of illicit drugs, typically to avoid law enforcement detection or other consequences of possession, and may present a serious medical emergency in patients. Most commonly, body stuffers ingest possibly large or unknown quantities of illicit substances to avoid detection of the drugs during apprehension. This ingestion is typically hasty or impulsive, and therefore the substances ingested are rarely packaged in a way that would be considered safe for ingestion.
This case highlights a series of rare complications of impacted esophageal foreign body including esophageal edema, pericarditis, and hydro-pneumothorax for a 16-year-old Hispanic male who was booked into a county juvenile detention and rehabilitation facility. He complained of persistent intractable epigastric pain, along with pleuritic chest pain with multiple episodes of vomiting over the previous 4 days. He denied swallowing any foreign body. He underwent esophagogastroduodenoscopy, and a plastic bag with content suspicious for marijuana was discovered in the distal esophagus and removed.
Failure to consider body stuffing and foreign body impaction in individuals during medical evaluation in detention centers with complaints of chest pain, abdominal pain, dysphagia, and/or certain toxidromes can delay diagnosis and lead to a variety of medical complications.
体内藏毒和包裹藏毒是两种隐藏非法药物的方法。体内藏毒是指将非法药物经口摄入，通常是为了避免执法部门的检测或拥有毒品的其他后果，可能会使患者出现严重的医疗紧急情况。最常见的是，体内藏毒者为了避免在被捕时被发现毒品，会摄入可能大量或未知数量的非法物质。这种摄入通常是仓促或冲动的，因此摄入的物质很少以被认为安全的方式包装。
本病例突出了一个罕见的食管异物嵌塞并发症系列，包括一名 16 岁西班牙裔男性的食管水肿、心包炎和液气胸，该患者被关押在县少年拘留和康复中心。他主诉持续性难治性上腹痛，伴有胸膜炎性胸痛，并在过去 4 天内多次呕吐。他否认吞咽任何异物。他接受了食管胃十二指肠镜检查，在远端食管发现并取出了一个装有疑似大麻的塑料袋。
在拘留中心，对有胸痛、腹痛、吞咽困难和/或某些中毒症状的患者进行医疗评估时，如果不考虑体内藏毒和异物嵌塞，可能会延迟诊断，并导致各种医疗并发症。
