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Elevated ALT, Subcapsular Fluid Collection, Possibly A Hematoma. Metabolic Panel Test Normal. Advice?

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Posted on Sat, 18 May 2013
Question: 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 ?
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Answered by Dr. Ajit Naniksingh Kukreja (9 hours later)
Hi

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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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ajit Naniksingh Kukreja

Gastrointestinal Surgeon

Practicing since :1984

Answered : 925 Questions

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Elevated ALT, Subcapsular Fluid Collection, Possibly A Hematoma. Metabolic Panel Test Normal. Advice?

Hi

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