Toxicology: body packer management: practice question

A Forensic Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Forensic Medicine · Toxicology: body packer management

Sample item

A man arriving on an international flight has an abdominal radiograph showing multiple uniform ovoid packets in the bowel. He is asymptomatic with normal vital signs. What is the most appropriate management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Whole bowel irrigation with polyethylene glycol and observation until all packets have passed

In an asymptomatic body packer, packets are best passed naturally with whole bowel irrigation and monitoring, with serial imaging. Endoscopic retrieval risks rupture and fatal overdose, and surgery is reserved for obstruction, packet rupture with toxicity or failure to pass. Emesis is unsafe.

Option by option

  • A. Whole bowel irrigation with polyethylene glycol and observation until all packets have passed (correct)

    Correct. Whole bowel irrigation and monitoring is the standard conservative approach.

  • B. Immediate endoscopic retrieval of the packets

    Endoscopic retrieval risks packet rupture and is avoided.

  • C. Induced vomiting with ipecac

    Induced vomiting cannot remove packets in the bowel and risks aspiration.

  • D. Immediate laparotomy

    Laparotomy is for obstruction, rupture or toxicity, which this man lacks.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is A, Whole bowel irrigation with polyethylene glycol and observation until all packets have passed. In an asymptomatic body packer, packets are best passed naturally with whole bowel irrigation and monitoring, with serial imaging.

Why is "Immediate endoscopic retrieval of the packets" not the answer?

Endoscopic retrieval risks packet rupture and is avoided.

Why is "Induced vomiting with ipecac" not the answer?

Induced vomiting cannot remove packets in the bowel and risks aspiration.

Why is "Immediate laparotomy" not the answer?

Laparotomy is for obstruction, rupture or toxicity, which this man lacks.

What concept does this question test?

It tests Toxicology: body packer management in Forensic Medicine. Endoscopic retrieval risks rupture and fatal overdose, and surgery is reserved for obstruction, packet rupture with toxicity or failure to pass. Emesis is unsafe.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Toxicology: body packer management?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.