Letalno trovanje kokainom kod body packer-a
Sažetak
Kod osoba koje krijumčare drogu u svojim telesnim šupljinama može doći do pojave sindroma body packer, odnosno teškog trovanja, ili iznenadne smrti. U slučaju letalnog ishoda prilikom prenošenja kokaina, važno je, ali ponekad i jako teško, utvrditi da li je smrt nastupila usled intoksikacije. Zbog toga je značajno ne samo kvantifikovati kokain i njegove metabolite u biološkom materijalu, već i na osnovu njihove raspodele u telesnim tečnostima i tkivima zaključiti da li se radi o akutnoj intoksikaciji. Opisali smo dobro dokumentovani slučaj letalnog trovanja kod body packer-a i post mortem raspodelu droge u biološkim uzorcima. Prikaz bolesnika. Kod 26-godišnjeg mladića neposredno pre prijema u bolnicu došlo je do prestanka vitalnih funkcija. Na prijemu je pokušana reanimacija, koja je ostala bez odgovora. Prilikom obdukcije u gastrointestinalnom traktu nađeno je 66 paketića kokaina, od kojih je jedan ruptuirao. Patološkim pregledom otkrivena je hiperemija unutrašnjih organa, edem pluća i mozga. Primenom metode tečne hromatografije sa masenom spektrometrijom (LC-MS) u post mortem biološkom materijalu dokazane su visoke koncentracije kokaina, njegovih metabolita benzoilekgonina i ekgonin-metil-estra, kao i levamisola koji predstavlja dodatak kokainu. Zaključak. Odnos konentracija kokaina i njegovih metabolita u mozgu i krvi koje su dobijene LC-MS metodom može se koristiti radi forenzičke potvrde akutne intoksikacije kokainom.
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