PURPOSE: Emergency departments are facing nowadays an increasing number of illegal drug-related health problems, associated with medicolegal and/or social consequences. Body stuffers are street cocaine dealers, who either store wrapped packets of drugs in their rectum or hastily swallow them, prompted by fear of police's arrest. These packets can be life threatening in case of leakage. We evaluate the diagnostic value of unenhanced multidetector CT (MDCT) for detection of cocaine-filled packets (CFP) ingested by body stuffers in a phantom model. MATERIALS AND METHODS: Our phantom simulated normal bowel contents in which a varying number of true and false CFP were randomly mixed. Both only differ in radiological density. During 18 different reading sessions, four radiologists independently evaluated the presence and number of true and false CFP. Interobserver agreement, sensitivity, specificity, positive and negative predictive value were calculated. RESULTS: Interobserver agreement for detection of any packets, for visualization of true, and false CFP was good (kappa=0.63, 0.74 and 0.58, respectively). Sensitivity, specificity, positive and negative predictive value for detection of any packets was 95.6%, 100%, 100% and 62.5%, respectively; for visualization of the true CFP 86.5%, 100%, 100% and 77.6%, respectively; and for the false packets 98.1%, 65%, 88.6% and 87.5%, respectively. CONCLUSION: Unenhanced MDCT without bowel preparation is a fast, reliable and easily reproducible imaging modality for the immediate detection of ingested CFP, thus facilitating medicolegal management of body stuffers.
PURPOSE: Emergency departments are facing nowadays an increasing number of illegal drug-related health problems, associated with medicolegal and/or social consequences. Body stuffers are street cocaine dealers, who either store wrapped packets of drugs in their rectum or hastily swallow them, prompted by fear of police's arrest. These packets can be life threatening in case of leakage. We evaluate the diagnostic value of unenhanced multidetector CT (MDCT) for detection of cocaine-filled packets (CFP) ingested by body stuffers in a phantom model. MATERIALS AND METHODS: Our phantom simulated normal bowel contents in which a varying number of true and false CFP were randomly mixed. Both only differ in radiological density. During 18 different reading sessions, four radiologists independently evaluated the presence and number of true and false CFP. Interobserver agreement, sensitivity, specificity, positive and negative predictive value were calculated. RESULTS: Interobserver agreement for detection of any packets, for visualization of true, and false CFP was good (kappa=0.63, 0.74 and 0.58, respectively). Sensitivity, specificity, positive and negative predictive value for detection of any packets was 95.6%, 100%, 100% and 62.5%, respectively; for visualization of the true CFP 86.5%, 100%, 100% and 77.6%, respectively; and for the false packets 98.1%, 65%, 88.6% and 87.5%, respectively. CONCLUSION: Unenhanced MDCT without bowel preparation is a fast, reliable and easily reproducible imaging modality for the immediate detection of ingested CFP, thus facilitating medicolegal management of body stuffers.
Authors: Oshry Mozes; Larisa Guranda; Orith Portnoy; Sara Apter; Eli Konen; Michal M Amitai Journal: Forensic Sci Med Pathol Date: 2014-10-19 Impact factor: 2.007
Authors: Joel Aissa; Johannes Boos; Christian Rubbert; Julian Caspers; Christoph Schleich; Christoph Thomas; Patric Kröpil; Gerald Antoch; Falk Miese Journal: Forensic Sci Med Pathol Date: 2017-03-07 Impact factor: 2.007
Authors: Jochen Grimm; Ramona Wudy; Edvard Ziegeler; Stefan Wirth; Michael Uhl; Maximilian F Reiser; Michael Scherr Journal: Int J Legal Med Date: 2014-02-28 Impact factor: 2.686
Authors: A Pinto; A Reginelli; F Pinto; G Sica; M Scaglione; F H Berger; L Romano; L Brunese Journal: Br J Radiol Date: 2014-02-03 Impact factor: 3.039
Authors: S N Abdul Rashid; S B Mohamad Saini; S Abdul Hamid; S J Muhammad; R Mahmud; M J Thali; P M Flach Journal: Br J Radiol Date: 2014-02-03 Impact factor: 3.039