Title : Peritonitis complicating body packing: A case report
Abstract:
Cocaine body packing, which is the intentional ingestion of drug-containing packets, has been a major risk factor for fatal consequences if a packet ruptures. Of these, peritonitis secondary to gastrointestinal perforation, though uncommon, is a surgical emergency with high mortality. Case Report: A 35-Year-Old Male with Generalized Peritonitis Following Ingestion of Multiple Cocaine Capsules. This case was recorded by a thorough review of clinical, laboratory, radiological, surgical, and postoperative information found in the patient’s documents. Emergency care was performed according to established medico-surgical guidelines. The patient had presented with acute abdominal pain and clinical presentation of diffuse peritonitis. Abdominal computed tomography (CT) showed 57 intracorporeal drug packets. The exploratory laparotomy finally resulted in the extraction of 85 cocaine capsules, several of which were fissured. The surgical procedure revealed a perforated cecal fistula with widespread purulent peritonitis. Despite timely surgical intervention and intensive care, the patient developed refractory septic shock and died on the fourth postoperative day. Here we see the exceptional but catastrophic complications that are expected from body packing, with GI perforation resulting in peritonitis being the most common. CT imaging is still the backbone of diagnosis, allowing rapid identification of packet location and complications. Yet the threat of systemic toxicity, infection, and multiorgan failure is high, even when all visible packets have been successfully extracted. Complications associated with body packing, particularly in otherwise healthy young individuals, are critical, as highlighted in the case. Early identification, speedy surgical approach, and aggressive critical care are necessary to achieve better outcomes. Thus, the report highlights the fatal consequences of drug body packing in the setting of bowel perforation and peritonitis, advocating for highly specialized multi-disciplinary solutions at high pressure in an emergency.
