Gross and Histopathological Changes in Lungs in Cases of Death Due to Acute Transoral Paraquat Poisoning

Background: Paraquat, a widely used herbicide, is associated with significant human toxicity, primarily affecting the lungs. Its ingestion leads to oxidative stress, inflammation, and progressive pulmonary damage. This study aims to correlate the gross and histopathological changes in the lungs of paraquat poisoning victims with the survival period.

Methods: This descriptive, cross-sectional study was conducted over six months, involving 24 cases of transoral paraquat poisoning. Lung specimens were examined macroscopically and microscopically for congestion, edema, hemorrhage, and fibrotic changes. Histopathological analysis included diffuse alveolar damage, inflammatory infiltrates, cellular vacuolization, and fibrosis. Data were analyzed descriptively.

Results: Macroscopic findings showed pulmonary hemorrhage (66.67%), congestion (62.5%), and edema (58.33%). Fibrotic changes were observed in 45.83%, primarily in cases surviving beyond 97 hours. Microscopically, diffuse alveolar damage (91.67%) and inflammatory infiltrates (100%) were prevalent. Fibrosis increased with survival duration, absent in deaths within 24 hours but pronounced in those surviving beyond one week. The findings align with existing literature, indicating paraquat-induced oxidative stress and a temporally progressive pathology.

Conclusion: Paraquat poisoning results in significant pulmonary pathology, characterized by congestion, hemorrhage, and progressive fibrosis. The severity correlates with survival duration, underscoring the need for timely intervention. Further research is essential to explore therapeutic strategies and improve clinical outcomes.