Swallowed drug-filled packet impaction and appendiceal neoplasm: Two rare causes of bowel obstruction detected in the same patient

Abstract

Bowel obstruction, perforation and acute drug overdose due to packet rupture are known complication of “body-packing”. We present the case of a 47-year-old man, who ingested drug-filled packets with acute bowel obstruction. A CT scan revealed multiple hyperdense ovoid bodies along distended and fluid-filled small bowel loops and an infiltrating appendiceal tumor with proximal packet retention. Peritoneal carcinomatosis was also observed. Urgent laparotomy confirmed the radiological findings. This study aims to highlight the coincidence of 2 exceedingly rare causes of bowel obstruction in a single patient and emphasize the need for meticulous finding evaluation in acutely ill patients to avoid the perceptual errors associated with “satisfaction of search” bias.