1. What must I do about abnormal LFT? KEVIN ROSENFELD Consultant Radiologist West Hertfordshire Hospitals Spire Hospital Harpenden Spire Hospital Bushey

2. Abnormal LFT Symptomatic or incidental finding Symptoms –Pain,nausea,LOW,known malignancy Ultrasound Pathology –Gallstones –neoplasm

3. Asymptomatic abnormal LFT Incidental finding

4. CASE 1 40 M Insurance medical Bloods:GGT 240 rest bloods normal What do next? Ultrasound GI referral Counsel patient nothing

5. CASE 2 55F Pneumonia Treated A/B Still unwell Bloods : AST 95 alk phos normal GGT 150 What next GI referral Ultrasound Stop AB and recheck bloods in 4 weeks

6. Management of asymptomatic abnormal LFT Draft guidelines BSG Not universally accepted West Herts adopted for primary care

8. Liver Metastases CT