Raised Alkaline Phosphatase and GGT

Patients with jaundice and anaemia due to haemolysis require admission.

Patients with raised alkaline phosphatase and GGT are likely to have biliary tract obstruction and should have a USS requested in the ED (with appropriate surgical/GI referral depending on the findings).

Patients with raised AST/ALT have hepatocellular injury and should be admitted if there is evidence of:

• Coagulopathy
• Sepsis
• Altered mental status
• Intractable pain/vomiting

Otherwise, outpatient investigation may be appropriate.