Strange

Sometimes, we run into circumstances we can't easily explain. I was recently scheduled for a straightforward spine surgery in an elderly woman. As I looked over her chart, I felt she was ready for surgery. Her blood tests the day before were perfectly normal. However, due to a fluke, on arrival on the day of surgery, she had her blood drawn again. Surprisingly, her liver function tests came back elevated. They went from normal to markedly abnormal within the span of sixteen hours. She had no changes in her health, symptoms, medications, alcohol intake, acetaminophen use, or exposures. We repeated the test and they were still abnormal. There was simply no explanation for the rapid rise in liver enzymes. As anesthesia can exacerbate hepatic injury and precipitate fulminant liver failure, we canceled the case. But this circumstance of unexpectedly changing lab results is unusual and I'm curious to see if we get any ultimate answers.