CT imaging of gastric and hepatic complications after ingestion of glacial acetic acid

OBJECTIVE: To document the computed tomographic (CT) image features of gastric and hepatic complications after ingestion of glacial acetic acid. MATERIALS AND METHODS: There were 5 patients (2 men and 3 women; age range, 2-84 years) who had ingested glacial acetic acid to commit suicide or accidentally. Their abdominal and chest CT scans were retrospectively reviewed to detect and evaluate visceral organ injury. Clinical and laboratory data were also reviewed. RESULTS: Diffuse edematous wall thickening of esophagus and stomach was observed in all patients. Three patients showed nonenhancing, wedge-shaped low densities in the liver on portal venous phase abdominal CT scans. These 3 patients also showed laboratory findings to indicate hepatic failure, hemolysis, metabolic acidosis, and disseminated intravascular coagulation. Two of these patients died despite vigorous supportive treatment. CONCLUSIONS: Wedge-shaped low densities can be seen in the liver on CT scans after ingestion of glacial acetic acid. They may represent hepatic necrosis caused by the direct effect of toxic materials absorbed into portal circulation.