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Clinical Trial
. 2021 Mar 8;11(1):5359.
doi: 10.1038/s41598-021-84898-z.

Complications and hospital stay after endoscopic retrieval of drug baggies in body stuffers: an observational prospective study

Mahtab Shabani  1 , Marzieh Kefayati  2 , Hossein Hassanian-Moghaddam  3   4 , Nasim Zamani  5   6 , Rebecca McDonald  7
Affiliations
Clinical Trial

Complications and hospital stay after endoscopic retrieval of drug baggies in body stuffers: an observational prospective study

Mahtab Shabani et al. Sci Rep. .

Abstract

Body stuffers routinely receive conservative treatment, i.e. administration of the laxative polyethylene glycol for the passage of ingested drug baggies and observation. Endoscopic baggie removal may offer a safe alternative that could result in shorter hospitalization. We aimed to compare complications, hospital stay, and final outcome in body stuffers assigned to endoscopy versus conservative treatment. This is an observational prospective study of body stuffers presenting to a clinical toxicology center in Tehran (Iran) in 2016-2019, irrespective of the drug ingested. Eligible patients had baggies in their upper gastrointestinal tract and presented without severe poisoning. Patients received either endoscopy or conservative treatment, and clinical outcomes were compared between the groups. A total of 69 patients were enrolled, with a median age of 29 years (range 18-64), among whom 1 was female (2%). Eighteen and 51 patients were endoscopically and conservatively managed, respectively. Drugs most commonly ingested were heroin in endoscopy patients (8/18 cases; 44%) and methamphetamine in the conservative group (28/51 cases; 55%). Endoscopy patients had a shorter hospital stay (median 1.5 vs. 2 days, P = 0.018). In the conservative group, one patient died, and the rate of complications was significantly higher, with more patients experiencing side effects (OR = 1.4, 95% CI = 1.2, 1.7) and requiring intubation (OR = 1.3, 95% CI = 1.1, 1.5). Endoscopic retrieval was associated with fewer complications and shorter hospitalization. Endoscopy may be a safe treatment for body stuffers without severe poisoning on presentation.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Lower left: Retrieved baggie by endoscope basket inside the stomach; upper left: Retrieved heroin baggie outside of the body after retieval; right: samples of methamphetamine baggies retrieved through endoscopy, the bottom baggie had opened in the stomach (prior to endoscopy).
Figure 2
Figure 2
Algorithm of patient recruitment.
See this image and copyright information in PMC

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