Background: Spontaneous bacterial peritonitis (SBP) is a commonly encountered complication of end stage liver disease that carries a high morbidity and mortality. Risk factors for SBP are defined by the American Association for the Study of Liver Diseases (AASLD) as a prior history of SBP, active gastrointestinal bleeding, and low ascites total protein (< 1.5 [...]

Case Presentation: 30-year-old male with no previous medical history presented with acute abdominal pain of 3 days duration. He noted abdominal distention for several years that was more prominent secondary to recent intentional weight loss. He denied periorbital edema, leg edema, dyspnea, orthopnea or PND. Examination revealed a protuberant abdomen with dull percussion note in [...]

Case Presentation: The patient is a 56-year-old Caucasian male who presented from an outside hospital (OSH) for recurrent chylous ascites. Four years ago, he was diagnosed with unprovoked left subclavian and left internal jugular deep vein thromboses (DVTs) and had been placed on chronic warfarin therapy. At that time, he developed chylous ascites which resolved [...]

Case Presentation: A 72-year-old man from Bangladesh, who immigrated to the U.S. 4 years ago, presented with ten days of constipation and progressively worsening abdominal pain. He reported no alcohol use, recent travel, known tuberculosis (TB) contact, IV drug use or incarceration history. The patient appeared frail and vital signs were within normal limits. His [...]

Case Presentation: A 50-year-old gentleman was admitted to the hospital medicine service for workup and evaluation of 3 days of epigastric abdominal pain. His history was significant for two recent admissions for episodes of acute pancreatitis within the preceding 2 months and alcohol use disorder (4 weeks sober) without cirrhosis. Physical exam was remarkable for [...]

Case Presentation: 48-year-old female with past medical history of cirrhosis secondary to HBV (on entecavir) and EtOH, decompensated by hepatic encephalopathy and ascites, coronary artery disease s/p stenting to LAD in 2009 presented to the hospital with abdominal pain and distension for a 1-week duration. She stated that the pain radiated to her back and [...]

Case Presentation: A 35-year female presented to the ED with complaints of worsening abdominal pain and distension without nausea, vomiting or diarrhea. The abdominal pain was diffuse in nature without radiation. She had fatigue, chills, intermittent fevers, and 10 pounds of weight loss over a month. The review of systems was otherwise negative. She was [...]

Case Presentation: A 53 year old male with history of decompensated non-alcoholic steatohepatitis cirrhosis (with ascites and esophageal varices), chronic kidney disease stage 3, type 2 diabetes mellitus, colon adenocarcinoma (TNM stage: T3N1) s/p FOLFOX (folinic acid, fluorouracil, and oxaliplatin) and right hemicolectomy 3 years ago was admitted from the liver clinic for acute kidney [...]