Title : Peritonitis complicating body packing: A case report
Abstract:
Cocaine body packing, which is the inten(onal inges(on of drug-containing packets, has been a major risk factor for fatal consequences if a packet ruptures. Of these, peritoni(s secondary to gastrointes(nal perfora(on, though uncommon, is a surgical emergency with high mortality. Case Report: A 35-Year-Old Male with Generalized Peritoni(s Following Inges(on of Mul(ple Cocaine Capsules. This case was recorded by a thorough review of clinical, laboratory, radiological, surgical, and postopera(ve informa(on found in the pa(ent’s documents. Emergency care was performed according to established medico-surgical guidelines. The pa(ent had presented with acute abdominal pain and clinical presenta(on of diffuse peritoni(s. Abdominal computed tomography (CT) showed 57 intracorporeal drug packets. The exploratory laparotomy finally resulted in the extrac(on of 85 cocaine capsules, several of which were fissured. The surgical procedure revealed a perforated cecal fistula with widespread purulent peritoni(s. Despite (mely surgical interven(on and intensive care, the pa(ent developed refractory sep(c shock and died on the fourth postopera(ve day. Here we see the excep(onal but catastrophic complica(ons that are expected from body packing, with GI perfora(on resul(ng in peritoni(s being the most common. CT imaging is s(ll the backbone of diagnosis, allowing rapid iden(fica(on of packet loca(on and complica(ons. Yet the threat of systemic toxicity, infec(on, and mul(organ failure is high, even when all visible packets have been successfully extracted. Complica(ons associated with body packing, par(cularly in otherwise healthy young individuals, are cri(cal, as highlighted in the case. Early iden(fica(on, speedy surgical approach, and aggressive cri(cal care are necessary to achieve be]er outcomes. Thus, the report highlights the fatal consequences of drug body packing in the se^ng of bowel perfora(on and peritoni(s, advoca(ng for highly specialized mul(-disciplinary solu(ons at high pressure in an emergency.
