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Human & Experimental Toxicology
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Peripheral Zonal Hepatic Necrosis Caused by Accidental Ingestion of Methyl Ethyl Ketone Peroxide

P.J. Karhunen

Department of Forensic Medicine, University of Helsinki, Kytösuontie 11, SF-00300 Helsinki, Finland

I. Ojanperä

Department of Forensic Medicine, University of Helsinki, Kytösuontie 11, SF-00300 Helsinki, Finland

K. Lalu

Department of Forensic Medicine, University of Helsinki, Kytösuontie 11, SF-00300 Helsinki, Finland

E. Vuori

Department of Forensic Medicine, University of Helsinki, Kytösuontie 11, SF-00300 Helsinki, Finland

Fatal massive peripheral zonal hepatic necrosis developed in a 47-year-old man who accidentally ingested a solution of methyl ethyl ketone peroxide (MEKP) in dimethyl phtalate. Such solutions contain about 10% active oxygen. The clinical course was characterized by temporary cardiac arrest, abdominal burns, severe metabolic acidosis, rapid hepatic failure, rhabdomyolysis and respiratory insufficiency. A fatal outcome resulted 4 d afterwards from hepatic coma associated with blood coagulation disorders. Microscopical examination revealed massive periportal hepatic necrosis accompanied by atypical pseudoductular proliferation. The proliferating cells were probably of bile duct origin and exhibited atypia and mitoses. The pathogenetic mechanism may involve lipid peroxidation caused by free oxygen radicals derived from MEKP.

Human & Experimental Toxicology, Vol. 9, No. 3, 197-200 (1990)
DOI: 10.1177/096032719000900315
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