CT scan of body packers: Findings and costs

Objective: To determine the CT features of intra abdominal illicit drug packs used for trafficking, by using scout CT scan image and describe its cost re-imbursementMethods: An observational study was conducted from January to December 2005, at the CT scan department, Civil Hospital, Karachi. The study subjects included alleged drug traffickers smuggling by body packing, intercepted at Karachi International Airport and referred for CT scan of abdomen by the Anti Narcotic department. Those with suspected body pack rupture were excluded. Scout CT image of the abdomen was taken. Scans were read on console as well as hard copy for the presence of radio opaque foreign bodies in the gut. The number, size in cm, density in H.U., and the site of foreign body in positive scans were noted. The cost of each scan in terms of technical expenditure and official reimbursement was also determined.Results: There were 11 alleged traffickers with 9 being males. Positive scans were obtained in 7 of whom 06 were males. All visualized foreign bodies were seen as high density objects (89-340 HU) compared to the surrounding tissues. The size ranged from 1.5-4 cms. All were multiple in number and variable in shape which was oval to elongated in 4 cases. The site was distal ileum in 1, ascending colon in 2 and transverse colon in 4 cases. The technical cost of each procedure was Pak Rs. 300-600 per case for which a reimbursement of Rs. 200-250 was received.Conclusion: Scout CT scan is good at picking ingested drug packs in the gut lumen. However the test should be conducted in liaison with the reporting radiologist with regard to the possible time of ingestion and rectal passage of foreign bodies. The cost is also under paid at public institutes

Radiology of COVID-19 - Imaging the pulmonary damage

A large part of the world is presently in the grip of the coronavirus disease (COVID-19) by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 virus), declared a pandemic in March 2020. This document is a brief commentary of the imaging modalities used in the screening, diagnosis and management of COVID-19 pneumonia. Chest x-rays, especially portable, still form a part of majority of official guidelines, with reports of the suggestive radiologic features. The potential of CT scan and ultrasound is also realised, with earlier detection rate. Typical radiologic findings of bilateral, asymmetrical, crazy-paved ground glass opacification, consolidation, reverse halo sign, opacities, progressing to fibrosis are well described for both the X-ray and CT scan. Atypical findings include airway changes, pleural effusion, pulmonary nodules and acute pulmonary embolism. Absence of lymphadenopathy, pleural effusion and pneumothorax is notable. The role of portable lung ultrasound, reported to be useful in emergency, is yet to be established in the guidelines. Disinfection of the equipment is a major concern. Governmental guidelines still advocate X-ray despite professional societies increasingly recommending CT scan