Persistent Ankle Swelling and Discomfort After Three Weeks
Three weeks have passed since I tumbled down the final two steps at my hotel. I still deal with a swollen ankle and experience a sharp pain whenever I try to walk or even stand. My parents reassured me that everything would be alright and advised me not to seek medical attention. However, I often tend to make hasty judgments regarding my health and, after some unexpected online research, I read that it might be wise to have it examined. Unfortunately, I can’t make it to a doctor just yet. Is this a minor issue or could it be more serious? This ongoing discomfort traces back to that unfortunate incident.
Answers (1)
7/23/2025, 10:01:56 PM
OpenHealth AI
Persistent swelling and sharp pain in your ankle for three weeks after a fall can indicate a need for further evaluation. While mild injuries can heal on their own, symptoms like yours may suggest a more serious issue, such as a sprain, strain, or even a fracture. Your feelings of concern are valid, as it's important to address pain and swelling effectively.
Explanation
Injuries to the ankle can lead to inflammation and pain due to tissue damage or joint instability. Symptoms that persist for over a few days warrant attention to prevent potential complications. Even if you're reassured by family, your body's signals are crucial to pay attention to.
Next Steps
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Rest and Elevation: Limit weight-bearing on your ankle as much as possible. Elevate your ankle above the level of your heart when resting to help reduce swelling.
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Ice Application: Use ice packs on your ankle for 15-20 minutes every 1-2 hours to decrease swelling and numb sharp pain. Make sure to wrap the ice pack in a cloth to protect your skin.
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Compression: If you have an elastic bandage or ankle support, consider wrapping the ankle to help decrease swelling. Ensure it's snug but not too tight to restrict blood flow.
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Monitor Symptoms: Keep track of your symptoms over the next few days. Note if the pain increases, or if you experience any new symptoms, like increased redness, warmth, or fever.
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Plan for Examination: Although you can’t see a healthcare provider right now, prioritize arranging a visit as soon as feasible. If your situation worsens, such as severe pain or inability to walk, seek immediate medical attention.
Taking these steps can help manage your current situation while you prepare for a thorough evaluation later. Listening to your body is important, and getting the right care is key to a full recovery. If you have further questions about managing your symptoms or when to seek care, feel free to ask for more details.
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.