John H, Renner N, Schönenberger R, Harder F
Departement Chirurgie, Universitätskliniken des Kantonsspitals Basel.
Helv Chir Acta. 1994 Dec;60(6):935-8.
The case of a 35-year-old man is reported, who presented himself in the emergency room with anxiety and hallucinations. He then passed a small oval pack consisting of a dark paste wrapped in cellophane with his stool. This led to the suspicion of a "body packer syndrome" with cocaine intoxication. The plain abdominal X-ray revealed multiple oval structure scattered over the entire gastrointestinal tract. Cocaine metabolites in the urine confirmed the diagnosis. During the following whole-bowel irrigation the patient had a grand mal seizure. In order to accelerate the retrieval of this threatening load, surgical evacuation was immediately executed. 78 packs containing 650 grams cocaine were removed through a gastrotomy and a coecotomy, respectively. Two of these packs were leaking. Following an uneventful postoperative course the patient was discharged from the hospital 11 days later. According to the literature the recommended treatment for cocaine body packers is whole bowel irrigation. Operative treatment is mandatory in cases of small bowel obstruction or drug intoxication due to leaking packs.
报告了一名35岁男性的病例，他因焦虑和幻觉前往急诊室就诊。随后他随粪便排出了一个小的椭圆形包裹，包裹由玻璃纸包裹着深色糊状物组成。这引发了对“人体藏毒综合征”伴可卡因中毒的怀疑。腹部平片显示整个胃肠道散在多个椭圆形结构。尿液中的可卡因代谢物证实了诊断。在随后的全肠道灌洗过程中，患者发生了癫痫大发作。为了加速取出这种有威胁的包裹，立即进行了手术清除。通过胃切开术和盲肠切开术分别取出了78个装有650克可卡因的包裹。其中两个包裹有渗漏。术后过程顺利，患者于11天后出院。根据文献，对于可卡因人体藏毒者推荐的治疗方法是全肠道灌洗。对于小肠梗阻或因包裹渗漏导致药物中毒的情况，手术治疗是必需的。
