Pedal I, Besserer K, Goerttler K, Heymer B, Mittmeyer H J, Oehmichen M, Schmähl D
Arch Toxicol. 1982 Jul;50(2):101-12. doi: 10.1007/BF00373392.
A case is reported in which progressive liver symptoms with rise in bilirubin concentration, hemorrhagic diathesis, and signs of portal hypertension developed three years before death in liver coma. The pathologic and neuropathologic findings are described. The case was clarified after dimethylnitrosamine was demonstrated in food intended for the patient and after it was established that small amounts of nitrosamine could have been repeatedly ingested by the patient over a period of years. Comparable cases of human dimethylnitrosamine poisonings published in the literature are presented. The relatively typical morphologic alterations in the liver are described. Problems involved in the histological interpretation of such liver changes as well as the forensic conclusions to be drawn are discussed.
本文报告了一例病例，患者在死于肝昏迷前三年出现进行性肝脏症状，胆红素浓度升高、出血素质和门静脉高压体征。描述了病理和神经病理学检查结果。在患者食用的食物中检测出二甲基亚硝胺，并确定患者在数年时间里可能反复摄入少量亚硝胺后，该病例得以明确。文中还列举了文献中发表的人类二甲基亚硝胺中毒的类似病例。描述了肝脏中相对典型的形态学改变。讨论了对此类肝脏变化进行组织学解释所涉及的问题以及得出的法医结论。
