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

Liver Metastases U/S

Liver Metastases CT

Fatty Liver Common ultrasound finding