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
Rob

For me LFT is NEVER really useful in trauma, except if they are in ICU and
on TPN!

Imaging is the way to go - risk over benefit: Risk of a potentially fatal
rebleed from a missed injury vs. about 1:1000 malignancy due to imaging.

Tim
Dr T C Hardcastle
M.B., Ch.B. (Stell); M. Med. (Chir) (Stell); FCS (SA)
Principal Specialist Trauma Surgeon /
Honorary Lecturer UKZN Dept Surgery
Deputy Director - IALCH Trauma Service

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