sodium-hypochlorite and Fibrosis

The authors present a series of 6 deaths due to the uncommon cause of chemical burns. Of the 6 deaths due to chemical burns, 4 deaths were due to ingestion of a chemical, 1 death was caused by chemical burns of the skin, and 1 death resulted from rectal insufflation of a chemical. Seven additional cases where chemical burns may have been a contributing factor to the death or an incidental finding are also presented. Four cases are related to an incident involving chemical exposure during an industrial explosion. Three cases involve motor fuel burns of the skin. Two cases concern a plane crash incident, and 1 case involved a vehicular collision. Cases are derived from the records of the Dallas County Medical Examiner's Office and those of the authors' consultation practices. Each of the cases is presented, followed by a discussion of the various mechanisms of chemical injury.

Topics: Accidents; Administration, Inhalation; Administration, Rectal; Adult; Burns, Chemical; Caustics; Disinfectants; Explosions; Female; Fibrosis; Forensic Pathology; Gastrointestinal Tract; Humans; Infant; Lye; Male; Mercuric Chloride; Middle Aged; Phosphoric Acids; Respiratory Aspiration; Respiratory System; Sepsis; Sodium Hypochlorite; Suicide

Cell suspensions of chemically induced tumors (rhabdomyosarcoma) were transplanted into the peritoneal cavities of Lewis rats. In normal animals, the greater omentum was the main site of tumor growth, and transdiaphragmatic metastases to regional lymph nodes in the mediastinum were few and small. In animals during the healing phase of a chemical peritonitis, the greater omentum was fibrotic, shrunken, and inactivated. The loss of the scavenging function of the omentum was associated with wide dissemination of the tumor in the peritoneal cavity and increased access of the tumor to the lymphatic stomata on the peritoneal surface of the diaphragm. Number and size of transdiaphragmatic metastases in draining lymph nodes were greatly increased in this postinflammatory state.

Topics: Animals; Female; Fibrosis; Liver; Lymph Nodes; Lymphatic Metastasis; Mesentery; Neoplasm Metastasis; Neoplasm Transplantation; Omentum; Peritoneal Cavity; Peritoneal Neoplasms; Peritonitis; Rats; Rats, Inbred Lew; Rhabdomyosarcoma; Sodium Hypochlorite; Spleen; Tumor Cells, Cultured

During the healing phase of a chemical peritonitis in rats, absorption of various inocula from the peritoneal cavity into the draining lymph nodes is increased. Heretofore, this phenomenon has been attributed to fibrosis and shrinkage of the greater omentum. The loss of the sequestering function of the omentum allows the inoculum more ready access to the lymphatic vessels in the diaphragm where it is absorbed. In the present work, it is demonstrated that the chemical peritonitis also widens the stomata in the roofs of the diaphragmatic lymphatic lacunes. Both increased access and larger openings contribute to enhanced lymphatic absorption in the postinflammatory state.

Topics: Absorption; Animals; Ascitic Fluid; Carbon; Coloring Agents; Diaphragm; Female; Fibrosis; Inflammation; Lymphatic System; Male; Omentum; Peritonitis; Rats; Rats, Inbred Lew; Sodium Hypochlorite