In a fatal occurrence of massive liver necrosis following ingestion of conc
entrated (90 %) acetic acid, the patient showed evidence of hemolysis, diss
eminated intravascular coagulation, and liver dysfunction at only 45 minute
s after exposure. With refractory to vigorous supportive care, the patient'
s condition deteriorated until death occurred 39 hours after ingestion, des
pite some improvement of coagulopathy. Autopsy revealed corrosive injuries
in the upper. gastrointestinal tract and massive hepatic necrosis in a peri
portal distribution without significant inflammation. A. direct effect of t
he noxious agent on hepatocytes involving the portal circulation is suggest
ed.