Clinical Outcomes and Management of Body Stuffing: A Retrospective Review

Abstract

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.