[Fatal poisoning by the rupture of intestinal bags of cocaine]

We report a case of rupture of bags filled with cocaine into the digestive apparatus in a young man. He carried into his digestive tract one hundred of small bags containing 40 g of cocaine each one. The initial clinical picture was characterized by sympathetic hyperactivity, rectorrhagia, and psychosis that evolved in 72 h to neurologic coma, convulsions, rhabdomyolysis, hyperthermia, hypocalcemia, hyperdynamic picture with negative blood cultures, arterial hypotension, syndrome of adult respiratory distress, and multiorgan failure. Treatment with propranolol, mechanic ventilation, barbiturates and inotropic agents was ineffective and the patient died 7 days after.