Erica S.

Rayos

Pathophysiology of Liver Abscess

Hello everyone! Our case for today is liver abscess of a patient in his 30’s. Based upon the
interview, we recognized some alarming modifiable risk factors in his lifestyle and food hygiene.
The patient is a heavy smoker and loves to eat junk foods on an empty stomach which compromise
his immune system and made him prone to infections. He also drinks a lot of liquor, frequently
since he was 10 year old and had just stopped lately when he felt an incomprehensible pain in his
abdomen. Studies not only suggest liquor to damage liver function but also locally brewed sorts
do have presence of amoeba. Another thing we notice on his narratives, the foods he eat were
always prepared by his relatives which brought us to the questions, “Are those foods cooked
properly, especially the meat?” and “Does the person who prepared the food practice good
hygiene?” Under the non-modifiable risk factor, experts say that this disease is more common to
males and age bracket 30-40.

First and foremost, liver abscess started with an infection by ingesting foods and drinks
contaminated by non-motile type of Entamoeba histolytica, a protozoan parasite in its infectious
stage. Then, from the stomach to the intestine, the cyst multiplied by asexual reproduction. Some
cyst leave the body using the feces as their vehicle. While the other cysts made its way to the liver
through the portal vein. Immediately after the non-motile parasites entered the liver using the
bloodstream, the host immune cells such us leukocytes and hepatocytes surrounded and tried to
neutralize them but some survived. But the cells, tissues, and immune cells which died during the
invasion and interact with each other formed an accumulation of pus or thick fluid. Those survivors
adapted to the immune cells and started to re-invade the liver. When the body detects that there
are still survivors, the immune system will send another immune cells to eliminate the remaining
bacteria, but failed again to wipe them all-out because some parasites will still survive. During this
repeating process, the pus in the segment 6 and 7 of the liver also increases in size and became a
large mass called abscess shown in the CT scan. Some of the symptoms that helped the medical
practitioners to diagnose the disease was nausea, vomiting and RUQ pain. There is also presence
of high direct bilirubin and an increase in Prothrombin time in Liver Function Test which indicates
that there is something wrong in the liver that leads to the diagnosis of the disease. After some
symptoms manifest and caused pain but been ignore due to financial problems, the patient
confirmed that he lose weight. Also, he experienced difficulty in sleeping and pain in the abdomen
as a post-surgery effect.