humulene and Foreign-Bodies

Pediatric button battery and cannabis ingestions are rising in incidence and have the potential for significant harm. This review will focus on the clinical presentation and complications of these two common inadvertent ingestions in children, as well as recent regulatory efforts and advocacy opportunities.. The rising incidence of cannabis toxicity in children has corresponded with its legalization across several countries in the last decade. Inadvertent pediatric cannabis intoxication is most commonly due to the ingestion of edible forms discovered by children in their own home. The clinical presentation can be nonspecific, therefore clinicians should have a low threshold for including it on their differential diagnosis. Button battery ingestions are also increasing in incidence. While many children are asymptomatic at presentation, button battery ingestions can quickly cause esophageal injury and lead to several serious and potentially life-threatening complications. Prompt recognition and removal of esophageal button batteries is essential for reducing harm.. Cannabis and button battery ingestions are important for physicians who take care of children to recognize and manage appropriately. Given their rising incidence, there are many opportunities for policy improvements and advocacy efforts to make a difference in preventing these ingestions altogether.

Topics: Cannabis; Child; Eating; Electric Power Supplies; Esophagus; Foreign Bodies; Humans

The body packing represents an illegal drug trafficking practice across the borders of certain countries. It has experienced enormous growth in recent years. The medical literature is rich in publications interested in body packaging of cocaine or heroin with sometimes lethal consequences. However, reported cases of cannabis body packing appear to be rare, sometimes underestimated, despite the notoriety of cannabis in the illegal drug market and its wide consumption around the world. We report in this work a forensic case of a cannabis body packer deceased due toa stercoral peritonitis secondary to a double perforation of thesigmoid and rectal colon.

Topics: Body Packing; Cannabis; Colon, Sigmoid; Drug Trafficking; Foreign Bodies; Humans; Intestinal Perforation; Male; Middle Aged; Peritonitis; Rectum

Rhinoliths are calcareous concretions of the nasal cavity formed around a nidus that may be endogenous (eg, dislodged tooth) or an exogenous foreign body (eg, plastic bead inserted by a child). Rhinoliths are often found incidentally on endoscopy or imaging to assess for other pathologies. The incidence is estimated to be 1 in 10 000 of all otolaryngology outpatient presentations, but this is likely to be an underestimate due to the often asymptomatic nature of this condition. We describe the unique case of a rhinolith that developed from a marijuana-filled balloon that the patient attempted to smuggle into a correctional facility. After inserting the package into his nostril, the patient then mistakenly believed it had been accidentally swallowed. Despite experiencing persistent symptoms of nasal obstruction and recurrent sinonasal infections, the marijuana package was only discovered 18 years after insertion following imaging for an unrelated indication.

Topics: Body Packing; Cannabis; Endoscopy; Foreign Bodies; Humans; Lithiasis; Male; Middle Aged; Nasal Obstruction; Prisoners; Tomography, X-Ray Computed

In recent years, numerous reports have been published on body packers, i.e. people who use their own body to transport drugs. Most body packers swallow small packages of cocaine or heroin.. We describe the case of a patient who, two days after ingestion of packages containing cannabis, was admitted for dizziness and drowsiness. Urinalysis was positive for cannabis and negative for other drugs. The deterioration in clinical status possibly indicated a burst package. The packages were surgically removed and the patient made a full recovery.. Some body packers transport other drugs than cocaine or heroin, such as cannabis. In body packers who ingest cannabis, depressed consciousness is a main symptom of intoxication. They should be admitted and monitored for symptoms of intoxication or paralytic ileus. Laboratory tests provide qualitative support when interpreting clinical symptoms. Surgical intervention is indicated in cases of bowel obstruction or when intoxication due to package leakage is suspected.

Topics: Adult; Body Packing; Cannabis; Foreign Bodies; Humans; Male; Radiography; Stomach; Young Adult

Illicit drug trafficking within the body ("body packers") represents a medical-legal problem currently on the rise. Endoscopic removal of drug packets is not generally recommended because of the risk of packet rupture and subsequent overdose on the spilled substance. A 40-year-old male presented with abdominal pain and diaphoresis following the ingestion of 30 g of hashish as a means of illegal trafficking, remaining in police custody during his hospital stay.

Topics: Abdominal Pain; Adult; Cannabis; Endoscopy, Gastrointestinal; Foreign Bodies; Humans; Ileum; Illicit Drugs; Male; Tomography, X-Ray Computed

Drug traffic is a major concern worldwide. We report a case of a 27-year old male who presented with a diffuse abdominal plain to the emergency department. Abdominal X-ray demonstrated multiple foreign bodies along the intestinal tract, which were found to be cannabis packets. The patient was treated conservatively with a good result.

Topics: Abdominal Pain; Adult; Cannabis; Drug Trafficking; Foreign Bodies; Humans; Illicit Drugs; Intestines; Male

"Body packers" swallow multiple packets filled with illicit drugs, mainly cocaine, in order to smuggle them across international borders. In recent years, an increasing number of body packers have been hospitalized after their detention by the police upon arrival in Israel.. To characterize the clinical features and outcomes of body packers hospitalized at the Sheba Medical Center.. We conducted a retrospective case series of body packers hospitalized between January 2010 and October 2012 in our medical center. Electronic medical records and imaging files were reviewed to extract clinical, laboratory and radiological data as well as details on medical treatments.. We identified 23 body packers (mean age 38 +/- 10 years), 20 of whom smuggled cocaine from South America. The number of packets transported ranged from 1 to 242 (median 42) and duration of hospitalization from 1 to 14 days (median 2). Two subjects required surgical intervention. All others were treated conservatively by polyethylene glycol-electrolyte lavage solution, laxatives, or watchful waiting. Ten patients underwent a urinary screen for illicit drugs, 7 of whom tested positive for cocaine and 2 for cannabinoids. Abdominal X-rays were performed in all patients at admission, and 14 had follow-up imaging, including abdominal CT scans without contrast media in 8.. The main treatment goals for body packers are the rapid excretion of drug packets and early detection of complications, i.e., drug intoxication and bowel obstruction. We suggest the use of a structured treatment approach for the in-hospital management of body packers.

Topics: Adult; Cannabis; Cocaine; Drug Packaging; Drug Trafficking; Female; Foreign Bodies; Gastrointestinal Tract; Hospitalization; Humans; Illicit Drugs; Israel; Male; Retrospective Studies; Young Adult

Topics: Cannabis; Drug Packaging; Foreign Bodies; Humans; Intestinal Obstruction; Intestines; Laparotomy; Male; Radiography; Young Adult

Topics: Adult; Cannabis; Drug Packaging; Foreign Bodies; Gastric Outlet Obstruction; Gastroscopy; Humans; Illicit Drugs; Male; Stomach

Body packing is a well-known means of narcotic carriage across international borders. The most common drugs carried are cocaine and heroin.. We describe 2 cases of cannabis body packing which occurred the same year in the South of France, one with complications: a 45-year-old male went to emergency for abdominal pain. A plain abdominal x-ray revealed multiple foreign bodies in the gastrointestinal tract. It was confirmed by abdominal CT. The laparatomy confirmed peritonitis secondary to colonic perforation, and 34 filled condoms packages were extracted. After calling poison centre, toxicological analysis was performed on one package. The resin wrapped in cellophane contained 15% tetrahydrocannabinol (THC). The patient was discharged on day 12.. Cannabis body packing is rarely reported, and the only known complications have a mechanic etiology. Plain abdominal x-ray is the best method for detection and it can be confirmed by abdominal CT and toxicological analysis. Cannabis is the most important illicit drug used in the word. Also cannabis body packing is probably underestimated. Health care practitioners should be aware of the possibility of body packing when someone coming back from abroad complains of abdominal pain.

Topics: Abdominal Pain; Adult; Cannabis; Condoms; Crime; Drug Packaging; Foreign Bodies; Humans; Male; Middle Aged; Radiography

Topics: Adult; Cannabis; Foreign Bodies; Hospitalization; Humans; Intestinal Perforation; Length of Stay; Male; Surgical Wound Infection; Time Factors

Body packing is a distinct method for smuggling drugs. What radiologists need to know is discussed in this pictorial review. Radiologists are confronted with diagnostic imaging of body packers because of two main reasons: complications of body packing and identifying drug packets within the gastrointestinal tract. The standard examination used is plain X-ray of the abdomen in an upright and a supine position. Computed tomography is occasionally used but nevertheless described as a very accurate diagnostic tool. Ultrasound and MR imaging do not play an important role in that field. Depending on the purity of the drug, three different forms of attenuation have been described: hashish is denser than stool; cocaine appears similar to stool; and heroin has a gaseous transparence. The packets are of a round to oval form, usually of a particular uniformity and rarely confused with scybala if arranged like a pearl chain; therefore, plain X-ray is the method of choice to detect drug-filled packets within the gastrointestinal tract of body packers.

Topics: Cannabis; Cocaine; Crime; Diagnostic Imaging; Digestive System; Female; Foreign Bodies; Heroin; Humans; Illicit Drugs; Male; Radiography

Drug smuggling by intra-abdominal concealment, so called "body packing," has recently increased, even in Japan. Because of fatal drug intoxication and other adverse side effects, it is important to make a radiological diagnosis of body packers as soon as possible. A retrospective analysis of the images of plain abdominal radiography, computed tomography (CT) and ultrasound (US) was performed in twenty-three body packers to evaluate the imaging characteristics of three drugs (cannabis, cocaine and heroin). Cannabis (16 patients) and cocaine (5 patients) packages were demonstrated as well-demarcated rectangular-shaped high-density shadows surrounded by gas halo ("double condom sign") in abdominal plain radiographs and CT. Heroin packages (2 patients) were demonstrated as obscure shadows and were difficult to identify on plain radiographs, because they resembled stool masses. US was performed in one cannabis patient because of the refusal of radiological examination, and packages were demonstrated as round echogenic structures with dorsal echo extinctions. In conclusion, abdominal plain radiography, CT and US represent valuable diagnostic modalities in the assessment of body packers.

Topics: Abdomen; Adult; Cannabis; Cocaine; Crime; Drug and Narcotic Control; Drug Packaging; Female; Foreign Bodies; Heroin; Humans; Male; Middle Aged; Radiography, Abdominal; Retrospective Studies; Tomography, X-Ray Computed; Travel; Ultrasonography

Topics: Adult; Cannabis; Foreign Bodies; Humans; Male; Penis; Prisoners

The extraction of impacted foreign bodies from the oesophagus is frequently performed using forceps under endoscopic guidance. We report the case of a 23-year-old prisoner who ingested a lump of cannabis resin which could not be removed from the upper oesophagus with forceps alone. We recommend the use of a Fogarty balloon catheter in conjunction with toothed forceps in such cases.

Topics: Adult; Cannabis; Catheterization; Esophagoscopy; Esophagus; Foreign Bodies; Humans; Male

ENT surgeons may well be asked to remove cannabis from the external ear where it has been lodged for various reasons. We report two cases and review four other cases we found in the literature to illustrate some of the difficulties. It is important that anyone working with people who abuse drugs are aware that cannabis can be concealed in the external ear.

Topics: Adult; Cannabis; Ear, External; Foreign Bodies; Humans; Instillation, Drug; Male; Olive Oil; Plant Oils

Ingestion of foreign bodies is a common cause of esophageal laceration and obstruction. Mediastinitis may occur if the problem is not managed expediently. A case of upper thoracic esophageal obstruction resulting from an attempted transenteric smuggling of illicit drugs is presented.

Topics: Adult; Cannabis; Esophageal Diseases; Esophagus; Foreign Bodies; Humans; Illicit Drugs; Male; Mediastinitis; Pleural Effusion; Subcutaneous Emphysema

The impaction of a cannabis-filled condom in the upper oesophagus of a 28-year-old prisoner is reported. The history was deceptive and smoking and drug abuse denied. The ENT surgeon being unaware of the identity of the drug faced tackling a possibly lethal foreign body, technically difficult to remove by the usual forceps method. (The Dormier basket is recommended for this task but we were unable to try it). Passage of the condom into the stomach occurred during attempted removal and its further progress was uneventful, indicating that gastroscopic removal of cannabis is unnecessary unless obstructive symptoms occur.

Topics: Adult; Cannabis; Contraceptive Devices, Male; Esophagoscopy; Esophagus; Foreign Bodies; Humans; Male; Prisoners; Radiography

The clinical, radiological and analytical aspects, and the complications observed in 16 cases of swallowing or insertion into the rectum of illicit drugs ("body-packing") are described. The drugs detected were heroin (6 cases), cocaine (5 cases) and cannabis (5 cases). In 15 cases abdominal plain X-rays were useful in the detection of the drug packages, their position and progression in the gastrointestinal tract and the presence of complications. The most valuable finding for radiologic diagnosis was the presence of a radiolucent halo surrounding the drug packages, or "double condom" sign, which was observed in 13/15 cases (87%). Urine analysis was positive for opiates or metabolites of cocaine in 7/9 cases (78%). One case presented acute heroin intoxication and three subjects gastric or intestinal obstruction requiring surgical treatment. In another case a packet, which had been retained in the stomach for five days, was extracted by upper gastrointestinal endoscopy using a Dormia basket with no complications.

Topics: Adult; Cannabis; Cocaine; Digestive System; Emergencies; Female; Foreign Bodies; Heroin; Humans; Illicit Drugs; Intestinal Obstruction; Male; Radiography

Topics: Arachis; Benzocaine; Cannabis; Chlorobenzenes; Chlorobutanol; Drug Combinations; Ear Canal; Female; Foreign Bodies; Oils; Plant Oils; Resins, Plant; Solutions

Topics: Adult; Cannabis; Crime; Diagnosis, Differential; Foreign Bodies; Humans; Ileal Diseases; Ileum; Intestinal Obstruction; Male; Tissue Adhesions

Four cases of attempts to smuggle narcotics (marijuana, heroin, and cocaine) by swallowing a large number of drug-filled foreign bodies (condoms and capsules) and hiding them from customs authorities in the gastrointestinal canal during transit are described. This is compared with a psychiatric patient who swallowed 48 Vicks Inhalers. Drug smuggling by swallowing condoms or capsules containing narcotics is now a worldwide ethical-legal problem. It also is of therapeutic and prognostic importance as this may lead to such emergencies as mechanical obstruction, rupture of the drug-containing foreign bodies, and life-threatening intoxication of the carrier.

Topics: Adult; Cannabis; Cocaine; Crime; Digestive System; Foreign Bodies; Heroin; Humans; Illicit Drugs; Male; Pharmaceutical Preparations; Radiography

Three cases of ingestion of balloons containing marihuana are reported. In 2 patients, balloons caused intestinal obstruction. In another patient, there were symptoms of drug overdose when the contents of the balloon spilled into the intestinal tract. Pure marihuana in the gastrointestinal tract has not been reported to cause death by intoxication; however, it may be mixed with more potent substances, especially cocaine. The ingested drug or drugs should be identified as soon as possible to avoid lethal intoxication if a balloon ruptures. A balloon containing drugs will usually pass spontaneously through an uncompromised gastrointestinal tract. Nonoperative management seems appropriate if the substance has been determined to be only marihuana.

Topics: Adult; Cannabis; Crime; Digestive System; Dronabinol; Foreign Bodies; Humans; Intestinal Obstruction; Male; Radiography; Rubber

Topics: Adult; Bradycardia; Cannabis; Electrocardiography; Foreign Bodies; Humans; Male; Oils; Phytotherapy; Radiography, Abdominal

The case is described of a patient with complete small bowel obstruction 13 days after swallowing a condom containing hashish. Treatment by enzymatic dissolution was obviously impossible. The small bowel was emptied preoperatively by a Dennis long-tube, and the impacted bolus was removed by enterotomy.

Topics: Adult; Cannabis; Foreign Bodies; Humans; Ileum; Intestinal Obstruction; Intubation, Gastrointestinal; Male; Rubber

Topics: Adolescent; Cannabis; Ear Canal; Female; Foreign Bodies; Humans; Skin Absorption