Mégarbane Bruno, Gharnaout Nawel, Djebrani Oussedik Nouzha
Department of Medical and Toxicological Critical Care, Federation of Toxicology, Lariboisière Hospital, APHP, Paris, France.
INSERM UMRS-1144, Paris Cité University, Paris, France.
Clin Toxicol (Phila). 2023 Apr;61(4):312-314. doi: 10.1080/15563650.2023.2192387. Epub 2023 Apr 5.
Diagnosis of body packing based on the misinterpretation of imaging is rare.
An unaccompanied 55-year-old woman presented with uncontrolled vomiting in the airport transit area. An abdominal radiograph and computed tomography scan revealed multiple radiopaque foreign bodies in the colon. History was unobtainable due to the language barrier. The patient was referred to our institution as a body packer who required surgical extraction of the packets. In the absence of symptoms, she was managed conservatively with antiemetic drugs and whole bowel irrigation. The final diagnosis was radiopaque pharmacobezoars caused by an over-the-counter barium-containing anticancer medication in the setting of severe hypokalemia-associated paralytic ileus following post-chemotherapy vomiting. After the correction of her potassium concentration, the patient was discharged and resumed her trip.
Clinicians should be warned that pharmacobezoars might be mistaken for drug packets on abdominal imaging leading to body packing misdiagnosis.
基于影像学误判诊断人体藏毒极为罕见。
一名无人陪伴的55岁女性在机场转机区域出现无法控制的呕吐。腹部X光片和计算机断层扫描显示结肠内有多个不透射线的异物。由于语言障碍，无法获取病史。该患者被转诊至我院，被诊断为人体藏毒者，需要手术取出包裹物。在无症状的情况下，对她进行了保守治疗，使用了止吐药物和全肠道灌洗。最终诊断为在化疗后呕吐导致严重低钾血症相关性麻痹性肠梗阻的情况下，由一种含钡的非处方抗癌药物引起的不透射线的药物性胃石。在纠正钾浓度后，患者出院并继续她的旅程。
临床医生应得到警示，药物性胃石在腹部影像学上可能被误认为是毒品包裹，从而导致人体藏毒的误诊。
