Booze Blues:
A Case Study on the Liver

Abstract: Peggy Fender is an intoxicated, 59 year old woman who is visiting the emergency department complaining of abdominal pain. She says the pain is in the upper right quadrant of her abdomen. The PA examines her and finds her emaciated, jaundiced, and many bruises covering her arms, legs, and face; her liver is hard and enlarged, along with her whole abdomen being ascitic (swollen and fluid-filled). Mrs. Fender isn't entirely coherent because she knows who she is and where she is, but she can't tell much about her illness. A blood test shows elevated blood transaminases (liver enzymes), high blood glucose, and prolonged prothrombin time (slowed clotting time). …show more content…

Fender's prolonged clotting times and excessive bruising are related. Again, referring to normal physiological functioning of the liver, why do these two things happen when alcohol damages hepatocytes?
The liver produces clotting proteins, so when cirrhosis occurs, the proteins don't produced like normal. This becomes visible with bruises.
The liver has a portal vein as well as a hepatic vein. It also has unique exchange blood vessels similar to capillaries, called “sinusoids.” How do these unique structures determine the function of the organ?
Most of the blood flowing to the liver comes through the portal vein from the intestines, stomach, and pancreas. This brings nutrients to the liver to either distribute to the body, or store until later needed. The other blood that comes to the liver is from the hepatic artery which ensures the liver gets oxygen. The sinusoids, within the liver, hold the incoming blood for a time in order to filter the blood before sending it on. (gastrohep.com)
Cirrhosis leads to scarring and increased hydrostatic pressure in the hepatic portal vein. Explain why this increased venous pressure causes net filtration to increase in the hepatic capillaries, leading to ascites (swollen and fluid-filled interstitial space of the abdomen).
When the oxidation of the alcohol happens, fatty infiltration occurs leading to inflammation and scarring of the liver. In the early stages, the infiltration is not associated with fibrosis and