special subjects
Body Packing and Body Stuffing
Treatment of Body Packing and Stuffing
Supportive treatment for complications Sometimes antidotes to specific drugs Sometimes measures to remove drug packets Treatment of patients with symptoms of overdose (and presumed packet rupture) is supportive and includes airway protection, respiratory and circulatory support, and antiseizure drugs, depending on patient symptoms. Sometimes, specific antidotes are indicated (see under specific drugs). Usually, unruptured packets in the gastrointestinal tract can be removed by Whole-bowel irrigation . However, once packets rupture, immediate surgical or endoscopic removal (depending on location in the gastrointestinal tract) of all packets is indicated but can rarely be done in time; death commonly occurs because the quantity of drug released is large. Patients with intestinal obstruction or perforation also need immediate surgery. Activated Vaginal and rectal packets should be removed manually. Asymptomatic body packers (and stuffers who have swallowed drug packets) should be observed for development of symptoms until the packets are passed and followed by several packet-free stools. Some clinicians use whole-bowel irrigation with apolyethylene glycolsolution with or withoutmetoclopramideas a promotility agent. Emergency endoscopy is not indicated for asymptomatic patients. 