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Study objective: To quantitatively assess cocaine liberation from various body packet materials. Design: 100-milligram cocaine packets (plastic bags with various wrapping techniques, paper, and condoms) were placed in a simulated gastric medium. Samples were also tested in an alkalinized gastric medium, with determination of both cocaine and benzoylecgonine concentrations using high-performance liquid chromatography with ultraviolet detection. Results: Cocaine liberation was greatest in acid medium, with increasing liberation from condom packets to cellophane bags (three wrapping techniques used) to paper packets. The same trend was noted in alkaline medium but with a far lower maximum cocaine concentration accompanied by rapid hydrolysis to its inactive metabolite, benzoylecgonine. Conclusion: Cocaine liberation of a known quantity of drug is dependent on the wrapping method and material used; thus, a good history from the "body-stuffer" is essential to predict potential cocaine liberation and toxicity. Rapid hydrolysis of cocaine to its inactive metabolite in an alkaline medium implies a role for gastric alkalinization in the acute management of these patients.

Soft tissue intranasal foreign bodies usually present as a well-defined syndrome in children 1 1/2 to 3 years of age who develop a chronic unilateral, purulent, fetid, unexplained rhinorrhea because the foreign material is not discovered in the nose on routine examination. Four cases are presented to document for the first time the anatomic location of soft tissue intranasal foreign bodies which become lodged in the anterior-superior aspect of the nasal cavity between the anterior edge of the middle turbinate and the bridge of the nose. No recurrence has been noted following removal of this material with the hemostat advanced superiorly inside the anterior border of the nose. One case with persistent rhinorrhea developed pneumonia and generalized body odor.