Splenomegaly, high b12, cirrhosis. B12?

Your reports suggest compensated liver cirrhosis, meaning your liver is affected but still maintaining its essential functions. There are no major red flags currently — no ascites, normal AFP, and stable blood counts — which are all good signs. 1. Spleen: Mild splenomegaly is expected in cirrhosis due to portal hypertension (increased pressure in the portal vein). The portal vein size of 11 mm is at the upper limit of normal and doesn’t need any intervention as long as there are no varices, bleeding, or low platelets. Continue carvedilol as it helps reduce portal pressure. 2. High B12: High serum B12 levels in liver disease are common because the damaged liver releases stored vitamin B12 into the blood. This does not indicate excess supplementation toxicity. You can stop additional B12 supplements for now and recheck levels after 2–3 months. 3. Blood Pressure / Portal Pressure: Blood pressure of 150/80 is slightly high; continue carvedilol and monitor regularly. Keep salt intake low and maintain hydration. 4. Liver Function & Follow-up: Since liver enzymes and AFP are stable and there’s no ascites, no invasive procedure is needed now. Continue periodic monitoring: • LFTs and renal function every 3 months • Ultrasound / Fibroscan every 6–12 months • Endoscopy once (to rule out varices, if not yet done)

• Avoid alcohol, unnecessary painkillers, and herbal medications. • Maintain a protein-rich, balanced diet unless advised otherwise. • Continue thyronorm, carvedilol, and other prescribed medicines. • Discuss with your hepatologist about screening endoscopy and hepatitis vaccinations (if not already done).

Your condition appears stable and well-compensated. The goal is to monitor regularly and prevent progression. No urgent intervention is required at this stage.