Hi.. An Endoscopy and CECT Abdomen should be done at baseline evaluation for any patient with cirrhosis. Nothing needs to be done for high B12. You may stop vitamin supplements for a while. If BP is on a higher range, increase CARVEDILOL to 3.125mg in morning and 6.2g in evening. It can be increased to 6.25mg twice daily as well if BP continues to be on a higher range.

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)