31st July 2023

A 32-year-old woman, with a background of essential thrombocytosis

A 32-year-old woman, with a background of essential thrombocytosis, presents with a 4-week history of progressively worsening abdominal pain and pruritus. On examination, she has scleral icterus, hepatomegaly, shifting dullness, and caput medusae. LFTs are mildly deranged, and the serum ascites albumin gradient is 0.9g/dL (normal range < 1.1).

What is the next stage of investigation?

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