Liver laceration

Q: Which of the following is the most reliable parameter of grading liver laceration/injury?

A) Aspartate aminotransferase (AST)
B) Alanine aminotransferase (ALT)
C) Level of Anemia
D) Blood Urea Nitrogen (BUN)
E) None of the above


Answer: E

None of the laboratory parameters are found to correlate well with the level of hepatic injury. This is a clinical diagnosis put together by history, physical exam and radiological workup such as a computed tomography (CT) with IV contrast, Focused Assessment with Sonography in Trauma (FAST), diagnostic peritoneal lavage (DPL) or diagnostic peritoneal aspiration (DPA) if clinically indicated, magnetic resonance imaging (MRI), and selectively arteriography.


Reference:

1. Koyama T, Hamada H, Nishida M, et al. Defining the optimal cut-off values for liver enzymes in diagnosing blunt liver injury. BMC Res Notes 2016; 9:41.