how sensitive are LFTs for liver injury in patients presenting >24 hours post injury?

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Colleagues -[ I realise this may have been previously discussed so
perhaps point me towards the archives] but...does anyone have at their
finger tips  evidence on the following scenario...



Patient presents to ED X-number of days post-moderate RUQ injury with
ongoing or perhaps mildy increasing R-sided pain [as opposed to sudden
exacerbation]...and has tender  R upper zone without frank signs, a
negative F.A.S.T scan and normal bloods including LFTs. I am aware of
the inadequate sensitivity of LFTs in the patient presenting shortly
after injury - but what is their sensitivity after 24 hours or 48 hours?



 I guess the question is driven by CT radiation exposure in the
paediatric population - but is applicable to adults



And ancillary question would be for a LUQ injury scenario for
sub-capsular splenic injury [given management is 72 hours bedrest] -
other than advice about contact sports etc is their benfit in CT for
those presenting 4 days or 7 days post-injury?



Many thanks

Rob Ojala







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