Predisposing factors Precipitating Factors

Living in a developing/tropical country food meals prepared with poor sanitation

water for drinking comes from a common tank of the entire town

ingestion of E. histolytica cyst

life cycle of E. histolytica continues and morphs into a metacystic trophozoite reaches and survives in the colon (especially the cecum)

nausea and vomiting- - - - - attachement to cecal mucosae and penetration of epithelium by lytic digestion aided by ameboid movement-------loose stools, loss of appetite

trphozoites burrow deeper

reaches muscularis mucosae

invades further into the mesentery towards portal venous system

Fans out laterally and
thrombos formation on branches of the portal vein due to lytic necrosis of ------- right upper quadrant pain ulcerate having a flask
portal vessel walls to generate pathway to lobules of liver shape

Obstructs blood flow, phagocytes (Kupffer) in the liver attack the invading trphozoites
Colon contraction
portal outflow to vena
trophozoite survivors of the attack continue to destroy neighboring liver cells squeezes colonies inside
cava
ulcers and are carried to
more leukocytes are called to aid in the attack-------- increased WBC, fever, chills
lower portions of the
Blood backs up and colon
development of by products of the encounter: live and dead leukocytes
causes portal cause by damage of liver cells bleeds into liver debris and forms liquefied
Bleeding anchovy paste
liver cells and trophozoites Liquid stools containing - - - bloody
Produces
mucousadditional ulcers in the colon
hypertension
walling off of inflamed area with its exudates to form an abscess
Increases capillary infiltration pressure If infection persists for months or years there will be massive destruc
HEPATIC ABSCESS

Direct extension of abscess from liver to lungs passing

through the diaphragm

Peritonitis, hemorrhage, perforation

Pushes fluids from
vessels to extra vascular
space abscess ruptures into pleural cavity

pleural effusion ------ sob, tachypnea, increase tactile fremitus

diminished breathsounds, egophony
Acscites ---- rigid
abdomen, bloating of
abdomen

Hepatocellular damage
or obstruction of bile
Hepatocytes decrease in ability to synthesize albumin canaliculi

Liver unable to
conjugate and excrete
Decreases capillary osmotic pressure bilirubin

Backs up to liver and

Decreases effective plasma volume reabsorbed into the
blood circulation

Increase in rennin, stimulation of vasopressin, aldosterone and antidiuretic hormone --- increase in BP
Bilirubin is deposited in
tissues ------- jaundice
 Increase renal reabsoprtion of Na and H20

Ascites, hemodilution, edema on distal extremeties