Sonographie bei intrakorporalem Drogenschmuggel

Um die Bedeutung der Sonographie zur Erfassung inkorporierter Drogenpäckchen (»body-packs«) zu überprüfen, wurden nach Erarbeitung sonographisch-diagnostischer Kriterien im Wasserbad zehn Probanden zwischen 23 und 30 Jahren, die je vier »body-packs« geschluckt hatten, sonographisch untersucht. Die »body-packs« bestanden aus mit festgepreßter Glucose gefüllten Fingerlingen mit einem Durchmesser von 1,5-1,8 cm. Im Wasserbadversuch zeigte sich als Identifikationskriterium der »body-packs« ein sichelförmiger Reflex mit dorsaler Schallauslöschung. Aufgrund dieses Kriteriums konnten bei acht der zehn Probanden 23 der 40 »body-packs« im Magen identifiziert werden. Dabei ließen sich innerhalb der ersten drei Stunden nach Ingestion bei acht Probanden 22 »body-packs« und nach etwa 17 Stunden bei vier Probanden neun »body-packs« im Magen nachweisen; nur bei einem Probanden gelang der Nachweis von zwei »body-packs« im Dünn-Dickdarm-Bereich. Da in der Praxis des intrakorporalen Drogenschmuggels zum möglichen Untersuchungszeitpunkt fast immer »body-packs« im Magen vorhanden sind, kann ein breiter Einsatz des Ultraschalls im Screening des Drogenschmuggels empfohlen werden.To evaluate the place of ultrasonography in the detection of intracorporeal drug packets (body-packs) ten volunteers were examined by ultrasound after having swallowed four body-packs each. Diagnostic criteria had first been established by ultrasound imaging of body-packs in a water bath. The body-packs contained fingerstalls, 1.5-1.8 cm in diameter, filled with hard-pressed glucose. The criterion for identification in the water-bath was shown to be a sickle-shaped echo with a dorsal echo deficit. This sign identified 23 of the 40 body-packs in eight of the ten subjects. Within the first three hours of ingestion 22 body-packs were demonstrated in eight of the subjects; after 17 hours nine body-packs were identified in the stomach of four subjects. In only one subject was it possible to identify (two) body-packs in the region of the small-large intestine. In practice, intracorporeal drug smugglers will almost always have the body-packs in the stomach at the time of likely examination. Extensive ultrasound screening of suspected smugglers is, therefore, recommended

Screening of Illegal Intracorporeal Containers ("Body Packing"): Is Abdominal Radiography Sufficiently Accurate? : a Comparative Study with Low-Dose CT

Purpose: To evaluate the diagnostic performance of abdominal radiography in the detection of illegal intracorporeal containers (hereafter, packets), with low-dose computed tomography (CT) as the reference standard. Materials and Methods: This study was approved by the institutional ethical review board, with written informed consent. From July 2007 to July 2010, 330 people (296 men, 34 women; mean age, 32 years [range, 18-55 years]) suspected of having ingested drug packets underwent supine abdominal radiography and low-dose CT. The presence or absence of packets at abdominal radiography was reported, with low-dose CT as the reference standard. The density and number of packets (≤12 or <12) at low-dose CT were recorded and analyzed to determine whether those variables influence interpretation of results at abdominal radiography. Results: Packets were detected at low-dose CT in 53 (16%) suspects. Sensitivity of abdominal radiography for depiction of packets was 0.77 (41 of 53), and specificity was 0.96 (267 of 277). The packets appeared isoattenuated to the bowel contents at low-dose CT in 16 (30%) of the 53 suspects with positive results. Nineteen (36%) of the 53 suspects with positive low-dose CT results had fewer than 12 packets. Packets that were isoattenuated at low-dose CT and a low number of packets (≤12) were both significantly associated with false-negative results at abdominal radiography (P = .004 and P = .016, respectively). Conclusion: Abdominal radiography is mainly limited by low sensitivity when compared with low-dose CT in the screening of people suspected of carrying drug packets. Low-dose CT is an effective imaging alternative to abdominal radiography. © RSNA, 201