Table 5
Author, date and countryPatient groupStudy type (level of evidence)OutcomesKey resultsStudy weaknesses
McCarron MM and Wood JD, 1983, USA48 suspected smugglers with ingested intra-corporeal cocaine packets 
 (number of packets per patient: 15–175)Prospective cohortComplete passage of packets per rectum47 patients
Emergency surgery1 patient with obstruction
Complications of conservative management2 patients developed cocaine toxicity due to packet
Caruana DS et al, 1984, USA50 patients with ingested intra-corporeal cocaine packets. 
 (number of packets passed per patient: 54–182)Retrospective cohortComplete passage of packets per rectum using conservative management.44 patientsTreatment environment unknown
Time from admission to onset of symptoms in the three patients who developed complications unknown
Elective surgery6 patients (their own choice)
Complications of conservative management3 patients required emergency surgery for obstruction
Aldrighetti L et al, 1996, Italy61 asymptomatic suspected smugglers with ingested intra-corporeal packets of cocaine 
 (number of packets ingested per patient: 52–117)Retrospective cohortComplete passage of packets per rectum using conservative management.61 patientsTreatment environment unknown
Time from admission to onset of symptoms in the obstructed patient unknown
Complications of conservative management2 patients required emergency surgery: 1 obstruction, 1 cocaine toxicity (on day 3 of admission
Bulstrode N et al, 2002, UK180 suspected smugglers with ingested intra-corporeal packets of contraband. 
 (number of packets per patient: 2–217)Retrospective cohortComplete passage of packets per rectum using conservative management144 asymptomatic body packersSeveral key details unknown, for example, exact management of the 144 packers who were not admitted and discharge criteria