Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 10 5 2026 05 04 233 235 Hadi Mirfazaelian Prehospital and Hospital Emergency Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Somayeh Mirbagheri Emergency medicine Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Khosrow Bagheri General Surgery Department, Shiraz University of Medical Sciences, Shiraz, Iran. 2025 12 24 2025 12 28 Body packing (ingesting drug-filled packets) is a well-known method of drug smuggling, especially among prisoners. It carries significant risks, including packet rupture, bowel obstruction, and life-threatening gastrointestinal bleeding. We present a 37-year-old male prisoner with a known history of peptic ulcer disease who presented with severe epigastric pain, coffee-ground vomiting, and hematochezia. Abdominal X-ray revealed multiple foreign objects consistent with drug packets. Due to ongoing bleeding and the rupture of one packet during removal, the patient underwent emergency surgical intervention. This case highlights the importance of early imaging, multidisciplinary management, and the need for surgical readiness in body packers with active bleeding. https://crcp.tums.ac.ir/index.php/crcp/article/view/1158 https://crcp.tums.ac.ir/index.php/crcp/article/download/1158/754