What must I do about abnormal LFT?KEVIN ROSENFELD

Consultant Radiologist

West Hertfordshire Hospitals

Spire Hospital Harpenden

Spire Hospital Bushey

Abnormal LFT

Symptomatic or incidental finding Symptoms

– Pain,nausea,LOW,known malignancy Ultrasound Pathology

– Gallstones– neoplasm

Asymptomatic abnormal LFT

Incidental finding

CASE 1

40 M Insurance medical Bloods:GGT 240 rest bloods normal What do next?

• Ultrasound• GI referral• Counsel patient• nothing

CASE 2

55F Pneumonia Treated A/B Still unwell Bloods : AST 95 alk phos normal GGT 150 What next

• GI referral• Ultrasound• Stop AB and recheck bloods in 4 weeks

Management of asymptomatic abnormal LFT

Draft guidelines BSG Not universally accepted West Herts adopted for primary care

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P E R S I S T E N T L Y A B N O R M A L L F T

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Liver Metastases U/S

Liver Metastases CT

Fatty Liver

Common ultrasound finding

F i g u r e 1 . S u g g e s t e d M a n a g e m e n t o f A b n o r m a l L F T s

C L I N I C A L S I T U A T I O N

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L I V E R S C R E E N i . e F u l l h i s t o r y , H B S A g , H C V A b ,

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P E R S I S T E N T L Y A B N O R M A L L F T

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C o n s i d e r t r e a t i n g u n d e r l y i n g d i s o r d e r e g P B C , h a e m o c h r o m a t o s i s o r a L i v e r B i o p s y

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