Diagnostic Dilemma


An 8 months old boy was diagnosed as hepatoblastoma at 4 months of age for which he underwent chemotherapy {4 cycles of PLADO regimen} and subsequently underwent right sided extensive hepatic resection at 8 months of age. Pre-operatively his LFT are shown in Table 1. Post operatively, in 24 hours, his LFT are depicted in Table 1 which shows marked elevation of liver transaminases with jaundice. He continued to have hemorrhagic ascitis though ascitic fluid cytospin was negative for malignant cells. He did have prolonged inferior vena clamping during intra operative period. He subsequently died after 6 days post operative.

What is the cause of this acute rise of liver enzymes_?
Expert Opinion :
It may be due to prolonged clamping of IVC and hepatic ischemia.
Answer Discussion :
habib jawaid
prolonged clamping ALT,AST very high equals Hepatic ischemia
10 years ago
DrSusanJohn Mathews
may be ischemia of liver
10 years ago

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