title: "Body packers" in Israel: a case series.
abstract: BACKGROUND
  "Body packers" swallow multiple packets filled with illicit drugs, mainly cocaine, in order to smuggle them across international borders. In recent years, an increasing number of body packers have been hospitalized after their detention by the police upon arrival in Israel.
  
  
  OBJECTIVE
  To characterize the clinical features and outcomes of body packers hospitalized at the Sheba Medical Center.
  
  
  METHODS
  We conducted a retrospective case series of body packers hospitalized between January 2010 and October 2012 in our medical center. Electronic medical records and imaging files were reviewed to extract clinical, laboratory and radiological data as well as details on medical treatments.
  
  
  RESULTS
  We identified 23 body packers (mean age 38 +/- 10 years), 20 of whom smuggled cocaine from South America. The number of packets transported ranged from 1 to 242 (median 42) and duration of hospitalization from 1 to 14 days (median 2). Two subjects required surgical intervention. All others were treated conservatively by polyethylene glycol-electrolyte lavage solution, laxatives, or watchful waiting. Ten patients underwent a urinary screen for illicit drugs, 7 of whom tested positive for cocaine and 2 for cannabinoids. Abdominal X-rays were performed in all patients at admission, and 14 had follow-up imaging, including abdominal CT scans without contrast media in 8.
  
  
  CONCLUSIONS
  The main treatment goals for body packers are the rapid excretion of drug packets and early detection of complications, i.e., drug intoxication and bowel obstruction. We suggest the use of a structured treatment approach for the in-hospital management of body packers.
authors.affiliation: Institute of Clinical Pharmacology and Toxicology, Sheba Medical Center, Tel Hashomer, Israel. noamarkovits@yahoo.com
authors.forename: Noa
authors.initials: N
authors.lastname: Markovits
authors.forename: Daniel
authors.initials: D
authors.lastname: Kurnik
authors.forename: Hillel
authors.initials: H
authors.lastname: Halkin
authors.forename: Larisa
authors.initials: L
authors.lastname: Guranda
authors.forename: Amir
authors.initials: A
authors.lastname: Cohen
authors.forename: Moshe
authors.initials: M
authors.lastname: Katz
authors.forename: David
authors.initials: D
authors.lastname: Olchovsky
authors.forename: Haim
authors.initials: H
authors.lastname: Mayan
authors.forename: Ronen
authors.initials: R
authors.lastname: Loebstein
mesh_terms: D000328:Adult; D002188:Cannabis; D003042:Cocaine; D004349:Drug Packaging; D064423:Drug Trafficking; D005260:Female; D005547:Foreign Bodies / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D041981:Gastrointestinal Tract; D006760:Hospitalization; D006801:Humans; D013287:Illicit Drugs; D007557:Israel; D008297:Male; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D013287:Illicit Drugs; D003042:Cocaine