When blood entering the hepatic circulation meets resistance by scarred tissue, blood flow is impeded and pressure increased in the
portal circulation. A second factor is an actual increase of portal blood flow due to release of endogenous vasodilators (Carale & Mukherjee, 2010).
The most common extraintestinal manifestation of amoebiasis is liver abscess, due to parasites gaining entry into the
portal circulation. This causes weight loss, right upper quadrant pain and fever.
When eggs are ingested by an intermediate host, the embryos escape, penetrate the intestinal mucosa, enter the
portal circulation, and are then trapped i the liver.4 Larvae develop into fluid-filled unilocu-lar hydatid cysts that consist of an external membrane and an inner germinal layer.
It is suggested that this fat depot, perfused by the
portal circulation, delivers substrates to the liver that in excess, can result in hepatic insulin resistance.