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May 16, 1977

Unusual Foreign Bodies in Bowel

JAMA. 1977;237(20):2225-2226. doi:10.1001/jama.1977.03270470061032

History  A 19-year-old man was brought into the emergency department in a stuporous state. Shortly after arrival, he had a grand mal seizure and vomited several times. He was admitted for observation.Examination showed a lethargic, sweating young man with slight abdominal tenderness and guarding. There were no other abnormal physical findings.Laboratory tests showed a moderate polymorphonuclear leukocytosis. There were decreased amplitude of T waves in all electrocardiographic leads and prominent U waves. A chest roentgenogram was normal. Blood gases indicated respiratory alkalosis. Ventilatory assistance was required during his ten-day hospital stay, during which time evidence of a respiratory infection developed, which cleared promptly on treatment. An abdominal roentgenogram (Figure) was taken on admission.

Diagnosis  Cocaine bags in the colon.

Comment  Multiple oval soft-tissue densities, each highlighted by a gas halo, are visible along the course of the colon and elsewhere in the abdomen in the Figure. These are