Successful Endoscopic Retrieval of Illicit Drug Packet

A 26-year-old female was brought into the emergency department in police custody with an alleged history of ingestion of a packet of heroin. To evade detection and law enforcement by police, the accused had hastily ingested the whole packet of heroin. On examination, her vital signs and oxygen saturation were normal. Her laboratory examination and urine toxicology screen demonstrated no abnormalities. She was explained the risk of leakage and acute toxicity from hasty ingestion of a poorly secured packet of drug. She consented to endoscopic retrieval, with naloxone drip and surgery team at the bedside, ready to change to an open exploratory laparotomy in the event of bag rupture. Her oesophagogastroduodenoscopy showed a white polythene packet with a knot in the stomach Figure 1. The packet was caught with a snare above the knot (the empty part of the packet) and retrieved whole without any leak Figure 2. She was discharged the same day, and the packet was handed over to the police. There are two distinct patterns of oral ingestion of drugs of abuse to evade detection: 'Body packing' is the planned well-coordinated ingestion for the purpose of smuggling, and "Body stuffing" is the hasty ingestion of drugs to evade law enforcement.1Figure 1: Endoscopic image showing a white packet in the stomachFigure 2: White packet with a knot containing illicit drugFinancial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.