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Sudden Change in Liver Condition After ERCP Treatment
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General Medicine
Question #46944
65 days ago
441

Sudden Change in Liver Condition After ERCP Treatment - #46944

Client_46f954

My father sri Nakul ch bose was suffering from cbd stone ,after ercp treatment and extraction of stone from bile duct on 22nd nov he was perfectly ok . he was discharged from AIG Hospital on 25 nov 2025 . His usg report on 24th nov shows normal size liver and normal portal vein. But after coming back to assam ,on observing bipedal edema of his leg with water filled blisters, local doctor advised to do USG On 20 december. The USG report surprisingly shows cirrohtic liver with portal vein hypertension and acsites. We are now surprised and helpless to see this reports. How from a normal liver to cirrhotic liver within 25 days possible. His LFT and KFT reports are also good except albumin- 2.55, and protein - 5 . His HB is 9. 1 ( which is almost remains same for the last 6-7 years).. He doesnot have any encephlaopathy and hunger is good. As we are from assam ,please advice what to do

How long has your father been experiencing the bipedal edema?:

- 1-2 weeks

Has he had any significant changes in his diet or lifestyle since the ERCP treatment?:

- Yes, major changes

Has your father experienced any other symptoms besides edema and blisters?:

- No other symptoms
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Key Points From Your Description

ERCP for CBD stone on 22 Nov → successful, patient improved USG on 24 Nov (AIG Hospital) → Normal liver, normal portal vein USG on 20 Dec (Assam) → reported cirrhotic liver + portal hypertension + ascites Labs: LFT: largely normal Albumin: low (2.55) Total protein: low (5) Hb: 9.1 (chronic anemia) Clinically: No encephalopathy Appetite good New onset bilateral pedal edema + water-filled blisters Very Important Understanding ❌ Cirrhosis does NOT develop in 25 days Cirrhosis takes years, not weeks.

Cirrhosis was overdiagnosed on the second USG, OR There is acute/reversible liver congestion or fluid overload mimicking cirrhosis on ultrasound

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YOUR FATHERS REPORTS SHOW VERY LOW ALBUMIN AND TOTAL PROTEIN AND THIS ALONE CAN CAUSE LEG SWELLING WATER FILLED BLISTERS AND FLUID IN ABDOMEN EVEN IF THE LIVER STRUCTURE IS NOT DAMAGED AFTER ERCP THE BODY GOES THROUGH STRESS INFLAMMATION AND FLUID SHIFTS AND IF PROTEIN LEVEL FALLS SUDDENLY ULTRASOUND CAN MISINTERPRET THIS AS CIRRHOTIC CHANGES OR PORTAL PRESSURE THIS IS CALLED FUNCTIONAL OR TEMPORARY DECOMPENSATION AND IT IS REVERSIBLE

THE MOST REASSURING SIGNS ARE GOOD APPETITE NO CONFUSION LFT AND KFT MOSTLY NORMAL RECENT ULTRASOUND BEFORE DISCHARGE WAS NORMAL HB LOW BUT STABLE

THIS DOES NOT FIT WITH END STAGE LIVER DISEASE

REPEAT ULTRASOUND WITH DOPPLER AFTER TWO TO THREE WEEKS REPEAT LFT ,INR, ALBUMIN, TOTAL PROTEIN,CHECK URINE PROTEIN CHECK ECHO, IF NOT DONE

FOCUS SHOULD BE ON IMPROVING PROTEIN LEVEL AND FLUID BALANCE SALT RESTRICTION PROPER PROTEIN IN DIET AS ADVISED BY DOCTOR LEG ELEVATION BLISTER CARE MONITOR WEIGHT AND URINE

FROM AN AYURVEDIC POINT OF VIEW PUNARNAVA MANDURA ONE TABLET TWICE DAILY AFTER FOOD TO HELP EDEMA IF APPROVED BY HIS DOCTOR DIGESTION SUPPORT VERY MILD FORMULATION BEFORE FOOD IF APPETITE IS WEAK

NO STRONG MEDICINES NO CLEANSING NO OIL NO HEAVY HERBS AT THIS STAGE

I NEED MORE DETAILS TO UNDERSTAND THE FULL PICTURE PROPERLY PLEASE TELL ME HIS AGE, ANY HISTORY OF ALCOHOL IN THE PAST , ANY LONG TERM MEDICINES LIKE PAINKILLERS ,ANTIBIOTICS ,OR HEART MEDICINES ANY HISTORY OF JAUNDICE IN THE PAST, ANY DIABETES, HIGH BP ,OR HEART PROBLEM ANY WEIGHT LOSS OR LOSS OF APPETITE IN LAST FEW MONTHS ANY FEVER OR INFECTION AFTER ERCP IS URINE OUTPUT NORMAL ANY ABDOMINAL PAIN OR TIGHTNESS ANY BREATHLESSNESS ON LYING DOWN ANY BLACK STOOLS OR VOMITING ANY MENTAL CONFUSION OR SLEEPIN

PLEASE SHARE THE DETAILS I ASKED ABOVE SO I CAN GUIDE YOU MORE CLEARLY AND SAFELY

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