Vojnosanitetski pregled 2016 Volume 73, Issue 2, Pages: 198-201
https://doi.org/10.2298/VSP141105022B
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Cited by
Fatal cocaine intoxication in a body packer
Brajković Gordana (Military Medical Academy, National Poison Control Centre, Belgrade)
Babić Gordana (Military Medical Academy, National Poison Control Centre, Belgrade)
Jović-Stošić Jasna (Military Medical Academy, National Poison Control Centre, Belgrade + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade)
Tomašević Gordana (Military Medical Academy, Forensic Medicine and Pathology, Belgrade)
Rančić Dragana (Military Medical Academy, National Poison Control Centre, Belgrade)
Kilibarda Vesna (Military Medical Academy, National Poison Control Centre, Belgrade + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade)
Introduction. ‘Body packer’ syndrome with severe intoxication or sudden death
may happen in persons who smuggle drugs in their body cavities. In case of
lethal outcome when carrying cocaine, it is important, but sometimes
difficult to determine whether death was due to intoxication or due to other
causes. Therefore, it is necessary not only to quantify cocaine and its
metabolites in biological material, but also based on their distribution in
body fluids and tissues to conclude whether it is acute intoxication. We
described a well-documented case of fatal poisoning in a body packer and post
mortem distribution of the drug in biological samples. Case report. A
26-year-old man was brought to hospital with no vital signs. Resuscitation
measures started at once, but with no success. Autopsy revealed 66 packets of
cocaine in his digestive tract, one of which was ruptured. Hyperemia of the
most of all internal organs and pulmonary and brain edema were found. High
concentrations of cocaine, its metabolites benzoylecgonine and ecgonine
methyl ester, as well as cocaine adulteration levamisole were proven in the
post mortem blood and tissues by liquid chromatography-mass spectrometry
(LC-MC) method with selective-ion monitoring. Conclusion. The ratio of
cocaine and its metabolites concentrations in the brain and blood obtained by
LC-MS method can be used for forensic confirmation of acute intoxication with
cocaine.
Keywords: cocaine, poisoning, deglutition, death+ sudden, diagnosis, differential, chromatography