CT scan of body packers: findings and costs.

OBJECTIVE To determine the CT features of intra abdominal illicit drug packs used for trafficking, by using scout CT scan image and describe its cost re-imbursement METHODS An observational study was conducted from January to December 2005, at the CT scan department, Civil Hospital, Karachi. The study subjects included alleged drug traffickers smuggling by body packing, intercepted at Karachi International Airport and referred for CT scan of abdomen by the Anti Narcotic department. Those with suspected body pack rupture were excluded. Scout CT image of the abdomen was taken. Scans were read on console as well as hard copy for the presence of radio opaque foreign bodies in the gut. The number, size in cm, density in H.U., and the site of foreign body in positive scans were noted. The cost of each scan in terms of technical expenditure and official reimbursement was also determined. RESULTS There were 11 alleged traffickers with 9 being males. Positive scans were obtained in 7 of whom 06 were males. All visualized foreign bodies were seen as high density objects (89-340 HU) compared to the surrounding tissues. The size ranged from 1.5-4 cms. All were multiple in number and variable in shape which was oval to elongated in 4 cases. The site was distal ileum in 1, ascending colon in 2 and transverse colon in 4 cases. The technical cost of each procedure was Pak Rs. 300-600 per case for which a reimbursement of Rs. 200-250 was received. CONCLUSION Scout CT scan is good at picking ingested drug packs in the gut lumen. However the test should be conducted in liaison with the reporting radiologist with regard to the possible time of ingestion and rectal passage of foreign bodies. The cost is also under paid at public institutes.