Initial diagnosis of a liver or pancreatic condition is likely to be carried out in a primary care setting by your family doctor. If the results of a physical examination and the blood tests taken by your GP indicate you may have a problem, you will be referred to a specialist clinician at a hospital.
As an outpatient at the Princess Grace Hospital with a suspected liver condition, you will be asked to provide more blood samples so we can test for liver function, the presence of any viruses (virology), and antibodies (immunology).
If you have suspected pancreatitis an initial blood test will be taken to measure whether the levels of blood pancreas enzymes are raised. An ultrasound or CT scan will also be used to see whether the pancreas is enlarged.
The liver function test will indicate to what extent your liver is inflamed and damaged. If any results are outside the range of ‘normal’ indications then further testing is likely to be advised. Different liver diseases will be indicated by different test results, but these tests are not in themselves 100 per cent conclusive.
The virology tests look for antigens and antibodies in your blood. Their presence indicates whether you have been infected by a virus in the past, or if you have a new infection, and how long that infection is likely to last.
You may also be advised to have an initial ultrasound scan of your upper abdomen (tummy).
Other state-of-the-art scanning/imaging equipment is also available at the Princess Grace Hospital and your diagnosis may be confirmed using X-ray technologies including magnetic resonance imaging (MRI), and computed tomography (CT) scan. These are all routine, painless and non-invasive procedures.
Other procedures you may be offered include endoscopic retrograde cholangiopancreatography (ERCP), a flexible endoscope which can help doctors examine your biliary and pancreatic structures. You may also have a liver biopsy or, as an alternative to a liver biopsy, a fibroscan.
If there are problems with the flow of blood to your liver an angiogram may be performed. An angiogram combines imaging technology with the use of a so-called ‘contrast medium’ injected into the artery through a catheter. The resulting images provide detailed information to your doctors about what’s happening to the flow of blood around your liver.