I had a 45 yo F w/ a history of chronic etoh abuse who came in intoxicated today and c/o 2-3 weeks of generalized abdominal pain, N/V/D. No Fevers or chills. On exam she had moderate diffuse TTP, most prominent in her RUQ. Her labs revealed a normal CBC, BMP, Lipase, but elevated LFTs (AST 1400, ALT 1300, AP normal, Tbili normal). Her last set of LFTs from 4 months ago were totally normal. She denied heavy tylenol use, was able to tolerate orals.... My plan was to discharge her home pending normal coags & a neg CT abdo/pelvis. I sent an acute viral hepatitis panel for her primary to follow up on. I'm curious how most of you guys manage patients you diagnose with acute undifferentiated hepatitis in the ER. Do you routinely image these patients in the ER (US or CT)? Do you discharge them with an acute hepatitis panel pending and have them follow-up with their primary doctor? Do you only admit patients who are toxic, have refractory emesis, or abnormal coags?