Diagnostic Accuracy of Liver Enzymes Tests for Detection of Liver Injury in Adult Patients with Blunt Abdominal Trauma in The Emergency Department at Suez Canal University Hospital

Background: Trauma remains a leading reason for death globally, with abdominal trauma responsible for 15–20% of trauma-related deaths. The hepatic is the 2^nd most injured organ in blunt abdominal trauma, typically diagnosed through imaging like focused assessment with sonography in trauma (FAST) or CT.
Aim: This study aimed to evaluate the diagnostic accuracy of liver enzymes Alanine Transaminase (ALT) & Aspartate Transaminase (AST) for the detection of liver injury in adult cases with blunt abdominal trauma (BAT) in addition to determining whether it has the possible to reduce the need for CT scans in cases with BAT.
Patients and methods: This descriptive cross-sectional research was performed on 97 cases. All were blunt abdominal trauma patients who attended to the Emergency Department (ED) at Suez Canal University Hospital and fulfilled our inclusion criteria.
Results: AST showed 82.4% sensitivity and 100% specificity for detecting liver injury, with 96.7% accuracy and strong agreement with CT. ALT and FAST together had 100% sensitivity and 75% specificity, with 80.5% accuracy. ALT alone had 94.5% sensitivity and 97% specificity; AST had 94% sensitivity and 96% specificity. FAST scan alone had 90.5% sensitivity, 100% specificity, and 96% accuracy in detecting blunt abdominal trauma, showing strong agreement with CT.
Conclusion: AST ≥ 108.2 U/L & ALT ≥ 80 U/L, combined with a positive FAST can help detect hepatic injury following BAT and guide management, especially where CT scans are not available.