Pharmacobezoar: a rare cause of body packing misdiagnosis

IntroductionDiagnosis of body packing based on the misinterpretation of imaging is rare.Case reportAn unaccompanied 55-year-old woman presented with uncontrolled vomiting in the airport transit area. An abdominal radiograph and computed tomography scan revealed multiple radiopaque foreign bodies in the colon. History was unobtainable due to the language barrier. The patient was referred to our institution as a body packer who required surgical extraction of the packets. In the absence of symptoms, she was managed conservatively with antiemetic drugs and whole bowel irrigation. The final diagnosis was radiopaque pharmacobezoars caused by an over-the-counter barium-containing anticancer medication in the setting of severe hypokalemia-associated paralytic ileus following post-chemotherapy vomiting. After the correction of her potassium concentration, the patient was discharged and resumed her trip.ConclusionClinicians should be warned that pharmacobezoars might be mistaken for drug packets on abdominal imaging leading to body packing misdiagnosis.

Automated summary

This article reports a case of misdiagnosis of body packing as a result of misinterpreting imaging results. A 55-year-old woman presented with uncontrolled vomiting in the airport transit area. Imaging showed multiple radiopaque foreign bodies in the colon, leading to the mistaken diagnosis. The final diagnosis was radiopaque pharmacobezoars caused by severe hypokalemia-associated paralytic ileus following post-chemotherapy vomiting.