Aortic dissection in a body packer: Did cocaine play a part?. (October 2021)

• Record Type: Journal Article
• Authors: Kévin, Mahé; Dufayet, Laurène; Nicolas, Soussy; Charlotte, Gorgiard; Dion, Elisabeth
• Is Part Of: Forensic science international. Volume 327(2021)
• Publication Date: 2021-10
• Subjects: Cocaine packets -- Body packer -- Computed tomography -- Aortic dissection; Medical jurisprudence -- Periodicals; Chemistry, Forensic -- Periodicals; Forensic Medicine -- Periodicals; Médecine légale -- Périodiques; Chimie légale -- Périodiques; Gerechtelijke geneeskunde; Gerechtelijke chemie; Gerechtelijke psychiatrie; Chemistry, Forensic; Medical jurisprudence; Electronic journals; Periodicals; Electronic journals; 614.1
• DOI: 10.1016/j.forsciint.2021.110963
• Languages: English
• ISSNs: 0379-0738

Abstract

Highlights: Case of a 63-year-old cocaine body packer who died of an aortic dissection. Cocaine impregnation causing high blood pressure might have played a role in the aortic dissection. Case highlighting the need for blood pressure monitoring in patients with cocaine packets. Abstract: 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.