### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I ve had increased liver enzymes for a couple of years now. I had my gallbladder out 2 years ago...I have an extensive history of endometriosis and after my second IVF child was born, I had a hysterectomy at 34. The endometrial tissue was in my abdomen and caused my appendix to be necrotic, I also had thyroid cancer at 34 ( just a quick hx). I m trying to figure out if my liver enzymes could be elevated due to possible endometrial tissue attaching itself to it. I continue to make hemorrhagic cysts ( currently have one on my left ovary). Yes, I still have both ovaries and I had a supra cervical hysterectomy. My doc has ordered an ultrasound of my liver to check for a fatty liver. I exercise everyday and eat pretty well. I m 5 ft 104 lbs....so I m not overweight. Given this info, do you have any suggestions r insight? I m an RN and I just want to be on top of this because my endometriosis went undiagnosed for over 10 years. I m 42.

### output:

Hi, Thanks for posting your query. I am Chat Doctor. There are many causes for raised liver enzymes. The most common cause being nonalcoholic fatty liver disease. Other causes include viral infections, liver toxic medications, autoimmune liver diseases, metabolic diseases of the liver. You must be aware of all these. Yes endometriosis can involve liver also. But it is very rare. You have to look for the more common causes first (which I have mentioned above). If the ultrasound scan shows any lesion and if other causes are ruled out, then a biopsy should be done to confirm the presence of endometrial tissue in the liver.