Hello, I brought my 9 year old son to the ER for severe lower abdominal pain. His brother had gastroenteritis 2 days earlier. In the ER, he was worked up for appendicitis, ultrasound was normal. Bloodwork was done after the US, which showed elevated SGOT 535 and SGPT at 238. T Bili was wnl, CBC was normal except for slight increase in platelets. UA had some red cells - I don't know how may, but a few over the normal value. He was d/c and sent home to f/u with pediatrician in 2 days, suspect viral hepatitis (Hep A, B & C were neg., monospot negative. He never threw up or had diarrhea, the pain subsided after a couple of hours in ER and was never located to the RUQ. F/U with ped- ordered repeat liver enzymes w/coags and abd. US, which were done 4 days after the first set of labs. Abd US showed slightly echogenic liver - (my son has a BMI of 14 is a skinny kid) everything else was normal on US. SGOT decreased to 90, SGPT was essentially the same and GGT was done, which was 250 (GGT wasn't done in the ER, so no comparative value). Pediatrician consulted with GI, who also suspects a viral hepatitis (maybe r/t gastroenteritis, even though he never threw up or had diarrhea/never had a fever). Coags were normal, lipid panel was normal. UA again had a few red cells over what was normal. The plan is to repeat the labs and UA in 2 weeks (no repeat US) - if all is back to normal, no f/u needed. If not normal, then f/u with GI. Does this sound like a viral hepatitis? 2 days after the ER visit, 2 of my other kids were throwing up with Gastroenetritis sx -- their elementary school had an outbreak of suspected norovirus and a huge number of kids were sick. I'm wondering if he passed a stone and that was what caused all of the pain and the liver enzymes were an incidental finding? My son never seemed "sick" - he is an active kid who loves sports/recess etc., so he was really upset to sit out for a few days. He never had any further abd. pain following that night in the ER and he was never tender on palpation (anywhere). Thoughts? Any suspicions that we are dealing with anything more sinister? Thank you