Blunt abdominal injury: serum ALT-A marker of liver injury and a guide to assessment of its severity.
BACKGROUND
Elevated serum alanine aminotransferase (ALT) as a marker for diagnosis, and assessment of severity in patients with blunt hepatic injuries are hitherto un-described or casually mentioned in literature.


METHODS
Prospective observational study of all patients admitted with blunt abdominal trauma accrued between May 2002 and December 2003. Upon admission, vital parameters were recorded and blood samples were drawn for haemogram and serum ALT (SGPT) levels. Patients were further evaluated with USG, CT scan or underwent a laparotomy.


RESULTS
Of the 122 patients with blunt abdominal injury, 32 had raised ALT, among these 31 had liver injury. No patient with a normal ALT had hepatic injury. Five patients with a significantly raised ALT and negative USG had liver injury. Patients with modestly raised ALT, mostly resolved on non-operative treatment, whereas, patients with more marked rise had more serious hepatic injuries, more complications, greater transfusion requirement, and higher death rates.


CONCLUSIONS
This observational cohort study strongly suggests that raised serum ALT is a sensitive diagnostic marker for blunt liver injury and its levels may assist with prognosis and guide management.
Srivastava
Aseem Ranjan
AR
Department of Surgery, King Georges Medical University, Lucknow, India. aseem_ranjan@hotmail.com
Kumar
Sandeep
S
Agarwal
G G
GG
Ranjan
Priyadarshi
P
D000007:Abdominal Injuries / Q000175:diagnosis*; D000293:Adolescent; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008099:Liver / Q000201:enzymology / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000175:diagnosis*; D011446:Prospective Studies; D012720:Severity of Illness Index; D014949:Wounds, Nonpenetrating / Q000175:diagnosis*
D015415:Biomarkers; D000410:Alanine Transaminase