Massive noninflammatory periportal liver necrosis following concentrated acetic acid ingestion

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.