• Logo
  • SBMUJournals

Case Report: Sudden Death of a Healthy Body Packer: A Case Study

Mehdi Forouzesh, Fardin Fallah




Background: “Body packing” is concealing illegal substances in the digestive system for smuggling or transfer across borders and “body packers” are those who carry these substances. Illegal substances are wrapped in packages that are swallowed by body packers and delivered at destination by defecation. The most common fatal consequence of body packing is intoxication due to rupture of packages in the body. Due to secret nature of this form of smuggling, accurate statistics on its prevalence and complications are lacking. Iran is a big consumer of opioids, located in the route of transfer of illicit substances from Afghanistan to other parts of the world, and also implement tight restrictions on the carriage and distribution of opioids; thus rate of body packing is expected to be high in this country (especially for opioids). In this report we present a young man’s sudden death with unknown cause in central part of Iran that was referred for autopsy.
Results: In the autopsy, 2237 g of opioid was found in his gastrointestinal system in the form of wrapped packages of which three were ruptured and caused fatal acute intoxication. The victim had no criminal records, however, he had psychological problems and was in low socioeconomic position.
Conclusion: This report underlines the importance of primary prevention programs with focus on susceptible groups which are usually people from low socioeconomic groups and are unaware of health risks of body packing and take part in this trade for financial benefits.


Body packer, Intoxication, Sudden death


Najafi N, Montazeri M. Heroin body packer’s death in Shiraz, Iran; a case report and literature review. Asia Pacific Journal of Medical Toxicology. 2017; 6(1):34-7. doi: 10.22038/apjmt.2017.8476

Esterson YB, Patel V, Nicastro J, Friedman B. Plain radiography may underestimate the burden of body packer ingestion: A case report. Clinical Imaging. 2017; 44:57-60. doi: 10.1016/j.clinimag.2017.04.006

Koehler SA, Ladham S, Rozin L, Shakir A, Omalu B, Dominick J, et al. The risk of body packing: a case of a fatal cocaine overdose. Forensic Science International. 2005; 151(1):81-4. doi: 10.1016/j.forsciint.2004.07.005

Flach PM, Ross SG, Ampanozi G, Ebert L, Germerott T, Hatch GM, et al. “Drug mules” as a radiological challenge: sensitivity and specificity in identifying internal cocaine in body packers, body pushers and body stuffers by computed tomography, plain radiography and Lodox. European Journal of Radiology. 2012; 81(10):2518-26. doi: 10.1016/j.ejrad.2011.11.025

Wetli CV, Rao A, Rao VJ. Fatal heroin body packing. The American Journal of Forensic Medicine and Pathology. 1997; 18(3):312-18. doi: 10.1097/00000433-199709000-00018

Hassanian-Moghaddam H, Abolmasoumi Z. Consequence of body packing of illicit drugs. Archives of Iranian Medicine 2007; 10(1):20-3. doi: 07101/AIM.006

De Bakker JK, Nanayakkara PWB, Geeraedts LMG, De Lange ESM, Mackintosh MO, Bonjer HJ. Body packers: a plea for conservative treatment. Langenbeck’s Archives of Surgery. 2011 8; 397(1):125–30. doi: 10.1007/s00423-011-0846-z

Berger FH, Nieboer KH, Goh GS, Pinto A, Scaglione M. Body packing: A review of general background, clinical and imaging aspects. La Radiologia Medica. 2015; 120(1):118-32. doi: 10.1007/s11547-014-0458-0

Goertemoeller S, Behrman A. The risky business of body packers and body stuffers. Journal of Emergency Nursing 2006; 32(6):541-4. doi: 10.1016/j.jen.2006.07.014

Cunningham N. Medicolegal issues surrounding body packers, pushers and stuffers. Emergency Medicine Australasia. 2012; 24(6):590-4. doi: 10.1111/1742-6723.12001

United Nations Office on Drugs And Crime (UNODC). World drug report 2010. New York: United Nations; 2010.

Alipour-faz A, Shadnia S, Mirhashemi SH, Peyvandi M, Oroei M, Shafagh O, et al. Assessing the epidemiological data and management methods of body packers admitted to a referral center in Iran. Medicine. 2016; 95(19):e3656. doi: 10.1097/md.0000000000003656

Mandava N, Chang RS, Wang JH, Bertocchi M, Yrad J, Allamaneni S, et al. Establishment of a definitive protocol for the diagnosis and management of body packers (drug mules). Emergency Medicine Journal. 2011; 28(2):98-101. doi: 10.1136/emj.2008.059717

Traub SJ, Kohn GL, Hoffman RS, Nelson LS. Pediatric “Body Packing”. Archives of Pediatrics & Adolescent Medicine. 2003; 157(2):174-7. doi: 10.1001/archpedi.157.2.174

Moosaei M, Garshasbi S. [Association between unemployment and opioid smuggling in Iran (Persian)]. Journal of Social Problems of Iran. 2011; 1(2):145-67.

Heinemann A, Miyaishi S, Iwersen S, Schmoldt A, Püschel K. Body-packing as cause of unexpected sudden death. Forensic Science International. 1998; 92(1):1-10. doi: 10.1016/s0379-0738(97)00192-8

Khodabandeh F, Afshar M, Khodabandeh A. [Investigation of victims of opiod packing ingestion referred to Tehran Legal Medicine Organization during five years (Persian)]. Scientific Journal of Forensic Medicine. 2004; 10(33):20-4.

Cunningham N. Medicolegal issues surrounding body packers, pushers and stuffers. Emergency Medicine Australia. 2012; 24(6):590-4. doi: 10.1111/1742-6723.120

DOI: https://doi.org/10.22037/ijmtfm.v7i4(Autumn).18669