A Curious Case of the Persistent Body Stuffer

Abstract EN

A 29-year-old male presented to our emergency department with complaint of abdominal pain after allegedly ingesting a 4-gram packet of heroin in an attempt to evade detection.

Initial evaluation including computed tomography (CT) of the abdomen/pelvis with intravenous and oral contrast, as well as laboratory workup was negative and the patient was discharged.

The patient returned 3 days later with complaint of “I feel high” and severe constipation, and demonstrated an opiate toxidrome requiring naloxone with improvement of symptoms.

A repeat CT of the abdomen/pelvis, this time without contrast revealed a 2.1 × 1.8 cm foreign body in the gastric antrum.

The patient was promptly taken to endoscopy with surgical backup.

Foreign body removal included multiple plastic bags encasing heroin, which had sustained a small leak causing a gastric outlet obstruction as well as a slow opiate toxidrome.

The foreign body was removed and the patient was observed and discharged with a favorable outcome.