APPROACH TO THE PATIENT WITH ABNORMAL LIVER-ENZYMES

Elevated serum enzyme values are often the earliest indicators of live r injury in asymptomatic patients. Abnormal AST and ALT point to a hep atocyte disorder; abnormal alkaline phosphatase suggests a biliary tra ct disorder. Selected case histories illustrate how the three enzyme l evels, in conjunction with the history and physical examination, can g uide the rest of the workup.