Posted in Psychology & Medicine

Viscera: Liver

(Learn more about the organs of the human bodies in other posts in the Viscera series here:

The liver is the second largest organ (next to the skin) in the human body, weighing about 1.4~1.6kg. It is found tucked under the right side of the ribcage, underneath the 5th to 10th rib in height and almost spanning the entire width of the trunk. When enlarged, the liver grows downward and can be felt in an abdominal exam (sometimes it is so large that it covers most of the abdomen).

It is a vital organ with many life-sustaining functions (hence “liver”) such as building various proteins, breaking down toxins, storing sugars in the form of glycogen, decomposing red blood cells and producing bile. The liver metabolises (breaks down) a large proportion of medications and drugs as it treats them as “toxins”. For example, the enzyme alcohol dehydrogenase breaks down alcohols into acetaldehyde, which causes hangovers and liver damage. Many Asians have a variant of this enzyme that is extremely efficient, causing a massive build-up of acetaldehyde when they drink alcohol. This is responsible for the so-called “Asian flush”.

Liver disease is associated a myriad of symptoms. The classic sign of jaundice (yellow skin and whites of eyes) is caused by obstruction of bile flow. Because of its location, pain in the right upper quadrant of the abdomen is commonly seen. As the liver is involved in synthesising various proteins, signs such as ascites (fluid in the abdomen) or bleeding may occur when the liver is damaged. A syndrome called portal hypertension is commonly seen in chronic liver disease such as cirrhosis as a major vein to the liver is blocked. This can cause an enlarged spleen, oesophageal varices that can bleed, ascites and prominent veins radiating from the belly button (caput medusae).

An interesting property of the liver is that it can regenerate at an amazing rate. A liver will regenerate to its original size even when a half of it is cut out (this is how live donor liver transplants work). What is more interesting is that the ancient Greeks probably knew of this fact as well. In Greek mythology, the gods punish Prometheus for bringing fire to humans by chaining him to a mountain and commanding an eagle to peck out his liver. The liver would then regenerate overnight and the eagle would return every morning to eviscerate him, causing him eternal anguish.


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