Histopatological findings of the liver before and during hepatic coma in fulminant hepatitis

The histopathological findings of the liver taken by needle biopsy before and during hepatic coma of fulminant hepatitis were studied in 3 patients; two died and one survived. In the first fatal case, massive hepatic necrosis was already present 7 days before the development of hepatic coma. In the second fatal case, submassive hepatic necrosis was seen during coma grade IV. In both cases, histological findings of the biopsy liver specimens were in accord with those of the autopsied liver. In the third survived case, diffuse degeneration and multilobular liver cell necrosis were found on the biopsy specimen taken immediately after the development of hepatic coma, grade IV.