Abstract :
Background: Annually about 2 million people suffer from various modes of burn injuries worldwide of whom more than a lakh die. In India about 60,000 people suffer from burns annually, more than 50,000 are treated in hospitals and about 10,000 succumb to thermal injury.
Aim: The primary importance of present study is to have a better understanding of changes occurring in this vital organ in relation to survival period of burn victims, to emphasis that hepatic dysfunction is also an important determinant to survival of burn victims.
Setting : Forensic Medicine and Toxicology Department of a tertiary care hospital.
Materials and Methods: A descriptive study was performed on 37 burn deceased of both the sexes of different age groups brought into the mortuary of the Department of Forensic Medicine during the period of July 2009 to December 2010. Liver specimens were collected and the H& E stained slides studied separately by two independent observers.
Results: Fatty infiltrations in the liver were present at various stages i.e. microvesicular steatosis to macrovesicular steatosis, followed by fatty cyst in victims with survival periods ranging from 2 days to 30 days. Thus as the survival period increased, the proportion of involvement of the hepatic lobule increased with focal / confluent centrilobular hepatocyte necrosis in 54.5% victims of 8-15 days survival and ultimately ended into massive hepatocyte necrosis leading to complete loss of lobular architecture in victims who survived for 16- 30 days.
Conclusion: The present study indicates that liver damage in the form of hepatic steatosis leading to hepatocyte necrosis and latter complete loss of liver architecture and consecutively hepatic dysfunction occurs with increasing survival period of burn victims therefore, maintenance of Liver integrity and function are crucial for post burn survival.
Keyword :
Burn injury, Hepatic steatosis, TBSA