A HISTOPATHOLOGICAL STUDY OF THE LIVER IN PARAQUAT POISONING: –An Analysis of Fourteen Autopsy Cases with Emphasis on Bile Duct Injury–

Abstract

Autopsy cases (14) of paraquat [herbicide] poisoning were studied. Of 8 patients who died within 4 days after ingestion of paraquat, 7 showed hepatocytic injury and 3 revealed bile duct injury. Hepatocytic injury was similar to that of CCl4 intoxication. Bile duct injury consisted of epithelial changes of bile ductules and bile ducts. Cholestasis in bile ducts was produced by injury. Affected bile ductules and ducts had hydropic and necrotic epithelium, associated with infiltration of neutrophils and histiocytes in intraductal and periductal tissues. Severity of bile duct injury increased gradually from bile ductules to septal bile ducts. Extrahepatic biliary tract showed the same injury as septal bile ducts in 1 case. Bile duct injury was produced by a direct corrosive effect of paraquat. Of 6 patients who survived more than 8 days, 5 revealed intrahepatic cholestasis, the pathogenesis of which was not clearly understood.