26th April 2024

A 47-year-old man presents with a two-week history of jaundice, abdominal pain, and swelling.

A 47-year-old man presents with a two-week history of jaundice, abdominal pain, and swelling. He admits to heavy alcohol consumption for many years. Recently, he has increased his alcohol intake following personal issues. He also reports nausea and a loss of appetite. On examination, he is jaundiced with an enlarged, tender liver and ascites. He has no history of liver disease or other significant medical conditions.

Investigations:

Liver function tests show elevated bilirubin, AST, and ALT with AST significantly higher than ALT.

Prothrombin time is prolonged.

Ultrasound of the abdomen confirms hepatomegaly and ascites, but no evidence of biliary obstruction.

Which is the most likely diagnosis?