Liver Enzymes as Predictors of Liver Damage Due to Blunt Abdominal Trauma in Children

Abstract

BACKGROUND: Blunt abdominal trauma in children can result in injury to the liver. In hemodynamically stable patients, initial evaluation of liver transaminase levels may be useful in determining the need for computed tomography (CT). METHODS: We reviewed the medical records of 44 hemodynamically stable children who had abdominal CT and who also had liver enzyme determinations as the initial workup. RESULTS: Liver enzymes were found to be elevated in all but one patient with CT confirmed hepatic injury. The sensitivity and specificity of elevated liver enzyme levels were 92.9% and 100%, respectively, for predicting liver injury. CONCLUSION: When hemodynamically stable pediatric patients with blunt abdominal trauma have AST levels >400 and/or ALT levels >250 IU/L, abdominal CT is indicated. Children in this study with serum transaminase levels below these values were at decreased risk of liver injury.