Massive noninflammatory periportal liver necrosis following concentrated acetic acid ingestion.
In a fatal occurrence of massive liver necrosis following ingestion of concentrated (90%) acetic acid, the patient showed evidence of hemolysis, disseminated intravascular coagulation, and liver dysfunction at only 45 minutes after exposure. With refractory to vigorous supportive care, the patient s condition deteriorated until death occurred 39 hours after ingestion, despite some improvement of coagulopathy. Autopsy revealed corrosive injuries in the upper gastrointestinal tract and massive hepatic necrosis in a periportal distribution without significant inflammation. A direct effect of the noxious agent on hepatocytes involving the portal circulation is suggested.
Kamijo
Y
Y
Departments of Emergency and Critical Care Medicine, Kitasato University, School of Medicine, Sagamihara, Kanagawa, Japan. yk119kitasatou.ac.jp
Soma
K
K
Iwabuchi
K
K
Ohwada
T
T
D019342:Acetic Acid / Q000506:poisoning*; D000328:Adult; D056486:Chemical and Drug Induced Liver Injury; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008099:Liver / Q000187:drug effects* / Q000473:pathology; D008107:Liver Diseases / Q000473:pathology; D009336:Necrosis; D013405:Suicide
D019342:Acetic Acid