Hello clauee,
We should wait until the biopsy results come back for the symptoms you describe are very nonspecific. Liver enlargement, hepatomegaly, could be acute inflammation, neoplasia, toxicity, secondary to heart disease, congenital, and others. The swollen abdomen is most likely excess peritoneal fluid. Is the CBD and bilirubin normal? Characterizing the fluid as either inflammatory, exudate, or transudate may help substantially.
I would like to address some of the abnormalities you discuss. First liver enzyme elevation is not always an indication of liver failure and large changes can occur with relatively mild insults to the liver. A mild heart murmur is also a common finding and may not indicate serious illness. So these changes may or may not be related to the main problem. The serious finding is weight loss in the face of good nutrition and deworming program. Let’s see if the biopsy suggests a diagnosis and if not consider further diagnostic testing like a peritoneal tap to check what is in the excess peritoneal fluid which may lead us to liver function tests (bile acids, bilirubin), checking for heart disease, and perhaps elsewhere.
DrO