Gastroenterology
Case 22: A Patient with Large‐Volume Ascites
CASE
An 83‐year‐old woman is seen in the out‐patient clinic with large‐volume ascites. She feels otherwise well although has experienced fatigue over recent weeks. She had previously undergone a transvaginal hysterectomy for prolapse. She takes aspirin, simvastatin and alendronate.
On examination she looks well. She has no palpable lymphadenopathy and no peripheral signs of chronic liver disease. On abdominal examination she has gross ascites but no detectable organomegaly or masses.
Blood tests showed:
Hb 11.3 g/dL WCC 8.4 × 109/L Platelets 256 × 109/L Na 137 mmol/L K 4.2 mmol/L Urea 11.2 mmol/L Creatinine 110 µmol/L Albumin 32 g/L Bilirubin 12 µmol/L ALP 136 U/L AST 14 U/L
An ascitic tap reveals a protein content of 28 g/dL.
QUESTION 1
Your score this session: 0 of 0
The best form of imaging to consider in this case would be: