A patient has the following results: AST 90 U/L; GGT 290 U/L; LIP 490 U/L; CREA 130 umol/L; Urinalysis: BIL 1+; UROBIL 0.2 Ehrlich unit. What is the suspected diagnosis?

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The key idea is recognizing a pattern of cholestasis (bile flow obstruction) in the liver test results. A markedly elevated GGT points toward bile duct involvement, since GGT rises specifically when bile flow is impaired. The presence of bilirubin in the urine (BIL 1+) indicates conjugated bilirubin is spilling into the urine, which happens when bilirubin is being conjugated in the liver but cannot be excreted into the intestine due to an obstruction.

Additionally, the very low amount of urobilinogen in the urine supports this picture. When bile flow is blocked, less bilirubin reaches the gut to be converted to urobilinogen, so urinary urobilinogen drops. That combination—high GGT, bilirubinuria with conjugated bilirubin, and low urinary urobilinogen—is characteristic of obstructive jaundice from cholestasis.

AST can be elevated with liver injury in general, and lipase may rise in pancreatobiliary conditions, but those findings don’t point to obstruction as clearly as the cholestasis pattern does. Renal issues or renal colic wouldn’t produce bilirubin in the urine with this specific urobilinogen profile.