Unité médico-judiciaire, Hôtel-Dieu University Hospital, APHP, 1 place du Parvis Notre-Dame, Paris 75004, France.
Unité médico-judiciaire, Hôtel-Dieu University Hospital, APHP, 1 place du Parvis Notre-Dame, Paris 75004, France; Université de Paris, UFR de médecine, 75010 Paris, France; INSERM UMRS 1144, Faculté de Pharmacie de Paris, 75006 Paris, France; Centre antipoison et de Toxicovigilance de Paris, Assistance Publique des Hôpitaux de Paris - Hôpital Fernand Widal, 75010 Paris, France.
Forensic Sci Int. 2021 Oct;327:110963. doi: 10.1016/j.forsciint.2021.110963. Epub 2021 Aug 20.
Body packing is defined as the ingestion of drug packets, to conceal them during transportation. We report the case of a 63-year-old cocaine body packer, who died from an aortic dissection. He was arrested in Paris as he disembarked from a flight from Cayenne (French Guinea) and custom officers found cocaine in his suitcase. The patient admitted the ingestion of cocaine packets. He was transferred to the hospital where an initial computerized tomography scan showed hyperdense, uniformly shaped packets located in the colon. On admission, his blood pressure was elevated but he did not exhibit any other signs of adrenergic syndrome. The diagnosis of chronic hypertension unrelated to the cocaine body packing was retained. During hospitalization, 40 h after the ingestion of the cocaine packets, the patient showed acute agitation, sweat and a high blood pressure. Given the context, an emergency thoraco-abdominal-pelvic CT-scan was carried out to rule out a cocaine leakage. None of the packets showed evidence of leakage but the CT-scan assessed an aortic dissection extending to the entire descending aorta. Despite intensive care, the patient passed away on the fifth day. This aortic dissection could have appeared spontaneously in a patient with significant atherosclerosis lesions of the aortic network. Nevertheless, we believe that cocaine impregnation causing high blood pressure might have played a role in the aortic dissection, even without a cocaine leakage from the packets. This case highlights the need to achieve an effective control of the blood pressure in cocaine body packers.
人体藏毒是指将毒品包裹物吞入体内，以便在运输过程中隐藏它们。我们报告了一例 63 岁的可卡因藏毒者，他因主动脉夹层而死亡。他在从卡宴（法属几内亚）起飞的航班上降落时被捕，海关官员在他的手提箱中发现了可卡因。该患者承认摄入了可卡因包裹物。他被转往医院，初步计算机断层扫描显示，在结肠中有高密度、均匀形状的包裹物。入院时，他的血压升高，但没有出现任何肾上腺素能综合征的迹象。保留了与可卡因藏毒无关的慢性高血压的诊断。在住院期间，即摄入可卡因包裹物后 40 小时，患者出现急性烦躁、出汗和高血压。鉴于这种情况，进行了紧急的胸腹盆腔 CT 扫描以排除可卡因泄漏。没有一个包裹物显示出泄漏的证据，但 CT 扫描评估了一个延伸到整个降主动脉的主动脉夹层。尽管进行了重症监护，患者还是在第五天去世了。这种主动脉夹层可能在主动脉网络有明显动脉粥样硬化病变的患者中自发性出现。然而，我们认为，可卡因浸渍导致的高血压可能在主动脉夹层中起作用，即使包裹物没有可卡因泄漏。这个病例强调了需要有效地控制可卡因藏毒者的血压。
