A 46 year old female with upper abdominal pain and abnormal liver functions which show:high bilirubin – is the patient jaundiced?

mild ALP elevation with significant GGT and ALT elevation which suggest a hepatitis like picture with an obstructive component. This is not primary obstructive liver disease.

Causes include:

Hepatitis

Cirrhosis

Liver metastases

Cholestatic disease

Pancreatitis

Alcoholism

Cardiac failure

The patient requires a thorough physical examination and investigations may include;

Bedside – UA, ECG, BSL

Lab – Hepatitis studies, LDH, Lipase, CRP, tumour markers and will be informed by the history and exam findings

Radiology – CXR, USS vs CT