[Surgery to save body-packers].
Cocaine body packing may expose to the risk of intestinal obstruction or acute cocaine poisoning. During the last five years (1998-2002), 17 symptomatic body-packers were admitted to our intensive care unit, for a closed monitoring. Clinical evolution of three patients required a surgical intervention. The first patient had a laparotomy, in the presence of an occlusive syndrome, to recover the packets of cocaine. The second patient presented peritonitis, in relation to an ileal perforation, treated with an intestinal segment resection followed by a double ileostomy. The third patient presented severe ventricular dysrhythmia, due to cocaine toxicity, after a bullet disruption in the stomach. Adrenaline and labetalol-combined therapy as well as gastric incision to recover the bullets were needed to allow cardiovascular stabilization. In these three cases, the surgical treatment allowed patient survival.
Mégarbane
B
B
Service de réanimation médicale et toxicologique, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France. bruno-megarbane@wanadoo.fr
Ekhérian
J M
JM
Couchard
A C
AC
Goldgran-Tolédano
D
D
Baud
F
F
D000316:Adrenergic alpha-Agonists / Q000627:therapeutic use; D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D000328:Adult; D001145:Arrhythmias, Cardiac / Q000139:chemically induced* / Q000628:therapy*; D003042:Cocaine / Q000506:poisoning*; D013505:Digestive System Surgical Procedures; D004359:Drug Therapy, Combination; D004632:Emergency Medical Services; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007081:Ileostomy; D007082:Ileum / Q000293:injuries* / Q000601:surgery; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D007416:Intestinal Perforation / Q000209:etiology / Q000601:surgery; D007741:Labetalol / Q000627:therapeutic use; D007813:Laparotomy; D008297:Male; D010538:Peritonitis / Q000209:etiology; D011041:Poisoning / Q000188:drug therapy / Q000601:surgery; D011859:Radiography; D019966:Substance-Related Disorders
D000316:Adrenergic alpha-Agonists; D000317:Adrenergic alpha-Antagonists; D003042:Cocaine; D007741:Labetalol; D004837:Epinephrine