Massive hepatic necrosis and death following repeated isoflurane exposure: case report and review of the literature.

Multiple exposures to halothane have been shown to produce hepatic injury and subsequent hepatic failure often leading to death. Isoflurane, a related haloalkane, is considered a nonhepatotoxic alternative to halothane and its potential to cause injury has been greeted with skepticism. Described is a 30-year-old woman who developed hepatic failure and died after being exposed twice to isoflurane. Recent exposure to anesthetic agents must be considered when death is caused by massive hepatic necrosis.