3
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Lin JH, Fang J, Wang D, Chen HZ, Guo Q, Guo XG, Han ST, He LP, He SX, Jiang HQ, Jin ZD, Li X, Liao Z, Mei B, Ren X, Tang YJ, Wang BM, Wang L, Xu H, Xu LM, Xue XC, Yang YX, Zhang XF, Zhang ZQ, Zheng HL, Zhi FC, Zhong L, Zou DW, Zou XP, Li ZS. Chinese expert consensus on the endoscopic management of foreign bodies in the upper gastrointestinal tract (2015, Shanghai, China). J Dig Dis 2016; 17:65-78. [PMID: 26805028 DOI: 10.1111/1751-2980.12318] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 01/06/2016] [Indexed: 12/11/2022]
Affiliation(s)
| | | | - Dong Wang
- Department of Gastroenterology.,Digestive Endoscopy Center
| | - He Zhong Chen
- Department of Cardiothoracic Surgery, Changhai Hospital, Second Military Medical University, Shanghai
| | - Qiang Guo
- Department of Gastroenterology, First People's Hospital of Yunnan Province, Kunming, Yunnan Province
| | - Xue Gang Guo
- Department of Gastroenterology, Xijing Hospital, Xi'an, Shaanxi Province
| | - Shu Tang Han
- Digestive Endoscopy Center, Jiangsu Provincial Hospital of Traditional Chinese Medicine, Nanjing, Jiangsu Province
| | - Li Ping He
- Digestive Endoscopy Center, Fujian Provincial Hospital, Fuzhou, Fujian Province
| | - Shui Xiang He
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province
| | - Hui Qing Jiang
- Department of Gastroenterology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province
| | - Zhen Dong Jin
- Department of Gastroenterology.,Digestive Endoscopy Center
| | - Xun Li
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu Province
| | - Zhuan Liao
- Department of Gastroenterology.,Digestive Endoscopy Center
| | - Bing Mei
- Department of Emergency Medicine, Changhai Hospital, Second Military Medical University, Shanghai
| | - Xu Ren
- Department of Gastroenterology, Heilongjiang Provincial Hospital, Harbin, Heilongjiang Province
| | - Yong Jin Tang
- Editorial Department of Chinese Journal of Digestive Endoscopy, Nanjing, Jiangsu Province
| | - Bang Mao Wang
- Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin
| | - Li Wang
- Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai
| | - Hong Xu
- Department of Gastrointestinal Surgery, The First Hospital of Jilin University, Changchun, Jilin Province
| | - Lei Ming Xu
- Department of Gastroenterology, Xinhua Hospital, Shanghai Jiao Tong University, Shanghai
| | - Xu Chao Xue
- Department of Gastrointestinal Surgery, Changhai Hospital, Second Military Medical University, Shanghai
| | - Yu Xiu Yang
- Department of Gastroenterology, Henan Provincial People's Hospital, Zhengzhou, Henan Province
| | - Xiao Feng Zhang
- Department of Gastroenterology, Hangzhou First People's Hospital, Hangzhou, Zhejiang Province
| | - Zi Qi Zhang
- Digestive Endoscopy Center, PLA General Hospital, Beijing
| | - Hong Liang Zheng
- Department of ENT, Changhai Hospital, Second Military Medical University, Shanghai
| | - Fa Chao Zhi
- Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province
| | - Liang Zhong
- Department of Gastroenterology, Huashan Hospital, Fudan University, Shanghai
| | - Duo Wu Zou
- Department of Gastroenterology.,Digestive Endoscopy Center
| | - Xiao Ping Zou
- Department of Gastroenterology, Nanjing Drum Tower Hospital, Nanjing, Jiangsu Province, China
| | - Zhao Shen Li
- Department of Gastroenterology.,Digestive Endoscopy Center
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Added value of lung window in detecting drug mules on non-contrast abdominal computed tomography. Radiol Med 2016; 121:472-7. [PMID: 26830789 DOI: 10.1007/s11547-015-0618-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Accepted: 12/21/2015] [Indexed: 01/08/2023]
Abstract
We evaluated the added value of lung window in non-contrast computed tomography (CT) of suspected body packers or stuffers. Forty suspected drug mules who were referred to our tertiary toxicology center were included. The final diagnosis of drug mule was based on the detection of packs in stool examination or surgery. Non-contrast CT scans were retrospectively interpreted by two blinded radiologists in consensus before and after reviewing the lung window images. The diagnostic performance of abdominal window scans alone and scans in both abdominal and lung windows were subsequently compared. Seven body packers and 21 body stuffers were identified. The sensitivity, negative predictive value (NPV), and diagnostic accuracy of scans in detection of drug mules (either drug packers or stuffers) raised from 60.7, 52.1, and 72.5 to 64.2, 54.5, and 75.0 %, respectively, with a more number of packs being detected (114 vs. 105 packs). In the body packers group, the diagnostic performance of both abdominal windows scans and combined abdominal and lung windows scans were 100 %. In the body stuffers group, the sensitivity, NPV, and diagnostic accuracy of scans increased from 47.6, 52.1, and 55.0 to 52.3, 54.5, and 57.5 %, respectively, after the addition of lung windows. Reviewing the lung window on non-contrast abdominal CT can be helpful in detection of drug mules.
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Bulakci M, Cengel F. The role of radiology in diagnosis and management of drug mules: an update with new challenges and new diagnostic tools. Br J Radiol 2016; 89:20150888. [PMID: 26867003 DOI: 10.1259/bjr.20150888] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Emergency physicians and radiologists have been increasingly encountering internal concealment of illegal drugs. The packages commonly contain powdered solid drugs such as cocaine, heroin, methamphetamine and hashish, but they may also contain cocaine in the liquid form. The second type of package has recently been more commonly encountered, and poses a greater diagnostic challenge. As clinical evaluation and laboratory tests frequently fail to make the correct diagnosis, imaging examination is typically required. Imaging methods assume a vital role in the diagnosis, follow-up and management. Abdominal X-ray, ultrasonography, CT and MRI are used for the imaging purposes. Among the aforementioned methods, low-dose CT is state-of-the-art in these cases. It is of paramount importance that radiologists have a full knowledge of the imaging characteristics of these packages and accurately guide physicians and security officials.
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Affiliation(s)
- Mesut Bulakci
- 1 Department of Radiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Ferhat Cengel
- 2 Department of Radiology, Haseki Training and Research Hospital, Istanbul, Turkey
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