• What is the Best Way to Remove a Bag of Methamphetamine From the Esophagus?

What is the Best Way to Remove a Bag of Methamphetamine From the Esophagus?

Researchers describe using endoscopy to remove an upper gastrointestinal obstruction caused by deliberate ingestion of illicit drug packets in the July issue of Clinical Gastroenterology and Hepatology.

Timothy Cowan et al report the case of a 30 year old man in police custody after ingesting a plastic bag containing methamphetamine. The patient complained of esophageal pain and was unable to swallow fluids, including his own saliva.

Computed tomography (CT) showed the bag lodged in his mid-esophagus (arrow, left side of figure).

Bag of methamphetamine lodged in the mid-esophagus following ingestion, by CT (left) and endoscopy (right).

Bag of methamphetamine lodged in the mid-esophagus following ingestion, by CT (left) and endoscopy (right).

The physicians performed endoscopy under general anesthesia 5 hrs after the patient ingested the bag, and confirmed complete esophageal obstruction (right side of figure).

The undamaged plastic bag was entirely removed using forceps and a Roth Net retriever.

The patient did not develop significant methamphetamine toxicity and was discharged from the hospital 24 hours after the procedure.

Cowan et al state that esophageal obstruction appears to be a rare complication of body stuffing (swallowing drugs in an unplanned attempt to escape police discovery)  or packing (swallowing large amounts of well-packaged drugs to transport them internationally).

The authors propose a role for endoscopy in treating cases of upper gastrointestinal obstruction caused by swallowed drug packets.

 

 

2 Comments

  1. Avatar
    Nayyar June 19, 2015

    Which forceps was used? Was it easy to grasp the plastic bag?

  2. Avatar
    Tim Cowan June 25, 2015

    Standard biopsy forceps were used to position the bag for retrieval using the Roth Net retriever. It wasn’t difficult to grasp the bag.

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