Clinical Outcomes and Management of Body Stuffing: A Retrospective Review.

INTRODUCTION

Body stuffing involves hastily ingesting poorly sealed drug packets for concealment. Management varies from no imaging to CT scans and observation for 6-24 h or until packet passage. This study describes the characteristics, management, and outcomes of body stuffers.

METHOD: A retrospective review was conducted on body stuffers reported to the NSW Poisons Information Centre and South-East Area Toxicology Service (2014-2023). Patients who ingested drugs for concealment were included. Body packers, body pushers, and cases without medical records were excluded. Data were collected from databases and medical records.

RESULTS

Of 192 patients, 126 met inclusion criteria (85% male, median age 30 years). Median time to presentation was 3.2 h (IQR: 1.7-6.6, n = 84). The median number of packages was one (IQR: 1-3), with balloons being the most common (56%). Concealed substances included opioids (39%) and amphetamines (29%). Thirty-two ingested multiple substances, while 26 denied or had unknown ingestion. Symptoms were present in 61 (48%), commonly sedation (19) or agitation (13). Symptomatic patients mostly concealed sedatives (29) or stimulants (28), while those ingesting tobacco or denying ingestion were usually asymptomatic. Imaging included abdominal X-ray (63) and CT (50). Sensitivity for X-ray and CT was 25% and 52% respectively. No asymptomatic patients developed symptoms during their stay. Twelve re-presented with new symptoms following discharge.

CONCLUSION

This study found that body stuffers concealed various drugs, with opioids and stimulants more likely to cause symptoms. Asymptomatic patients typically had a benign course. Imaging has limited sensitivity; reserving it for those with more high-risk features of exposure seems reasonable.