Brajković Gordana, Babić Gordana, Stosić Jasna Jović, Tomasević Gordana, Rancić Dragana, Kilibarda Vesna
Vojnosanit Pregl. 2016 Feb;73(2):198-201. doi: 10.2298/vsp141105022b.
'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.
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.
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.
“人体藏毒者”综合征伴严重中毒或猝死可能发生在通过体腔走私毒品的人身上。在携带可卡因导致致命后果的情况下，确定死亡是由于中毒还是其他原因很重要，但有时也很困难。因此，不仅有必要对生物材料中的可卡因及其代谢物进行定量，还需要根据它们在体液和组织中的分布来判断是否为急性中毒。我们描述了一例记录详实的人体藏毒者致命中毒病例以及死后毒品在生物样本中的分布情况。
一名26岁男子被送往医院时已无生命体征。立即开始复苏措施，但未成功。尸检发现其消化道内有66包可卡因，其中一包破裂。发现大部分内脏器官充血以及肺水肿和脑水肿。通过液相色谱 - 质谱联用（LC - MC）法结合选择性离子监测，在死后血液和组织中证实了高浓度的可卡因、其代谢物苯甲酰爱康宁和爱康宁甲酯以及可卡因掺杂物左旋咪唑。
通过LC - MS法获得的大脑和血液中可卡因及其代谢物浓度的比值可用于法医学上对可卡因急性中毒的确认。
