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Elevated ALT, subcapsular fluid collection, possibly a hematoma. Metabolic panel test normal. Advice?

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Gastroenterologist, Surgical
Practicing since : 1984
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I have elevated ALT 65 and ALT 44, had a MRI of abdomen w/wo contrast there is a 4.6 cm transverse x 1.7 cm AP T1 and T2 hypointense lesion within the subcapsular aspect of the right lobe of liver, which does not demonstrate enhancement following contrast administration. Findings most likely represent a subcapsular fluid collection, possibly a hematoma. No suspicious finding identified. Recommend short term follow up to document stability. All other blood test on Comprehensive Metabolic Panel are normal, Hepatitus B -Nonreactive, Hepatitus C -Nonreactive, Anti-Smooth Muscle Antibody -Negative, Anti-Mitochondrial Antibody -Negative, Anti-Nuclear Antibodies -Negative.
Can the hematoma be causing the elevated ALT and AST ?
Posted Tue, 14 May 2013 in Liver and Gall Bladder
Answered by Dr. Ajit Naniksingh Kukreja 9 hours later

Thanks for writing in

First concern would be to find out how did the hematoma occur, spontaneously or during gall bladder surgery [ Was the gall bladder surgery done laparoscopically ?]

If spontaneous you need to get a good evaluation done of your hemodynamic profile

If during surgery - the cause is known - treat conservatively if not increasing in size [Very unlikely to increase after one year of surgery]

With any intrahepatic insult the enzymes are raised - keep a watch and get repeated after three weeks, if they start increasing see a gastroentrologist

Hope this helps
Do write back in case of concern
Wishing you a healthy life ahead
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