My Patient Has Elevated Liver Function Tests · Choledocholithiasis. Sclerosing Cholangitis. My...
Transcript of My Patient Has Elevated Liver Function Tests · Choledocholithiasis. Sclerosing Cholangitis. My...
Liver Dysfunction
• Elevated ALT, AST, Non drinker
• Elevated ALT, AST, drinker
• Elevated Direct Bilirubin
• The Incidental Hepatic lesion
• Elevated
Elevated ALT and AST, Non drinkerUltrasound
Normal Fatty Infiltrated
CT MR
Persistent Pain
Confirm/Discordant with clinical
findings/Evaluate for cirrhosis/Pseduolesio
n due to focal fat
Biopsy
NAFLD NASHDo not suspect Medication, Alcohol or virus
Elevated Liver Function Tests, Alcohol Related
Ultrasound
Normal Acute Hepatitis Cirrhosis
Serial Ultrasound
CT MR
Elevated AFP, Clinical Concern for
Hepatocellular Cancer
Triphasic
Mass
Elevated Bilirubin
Elevated Direct
Evaluate for Obstruction
Ultrasound
Choledocholithiasis Normal
CT MR/MRCP
Intrinsic/Extrinsic Obstruction
Elevated Total Bilirubin
PrehepaticHepatic
Posthepatic
Triphasic
My patient has an incidental lesion
Ultrasound
Cyst Hyperechoic Lesion
CT MR
Triphasic
BenignFocal Nodular Hyperplasia
HemangiomaAdenoma
MalignantHCC
Cholangiocarcinoma
Metastasis