11th January 2024

A 45-year-old lady with a known history of alcohol excess presents to the Emergency Department, generally unwell with confusion, abdominal swelling and shortness of breath.

A 45-year-old lady with a known history of alcohol excess presents to the Emergency Department, generally unwell with confusion, abdominal swelling and shortness of breath. She is unable to give a coherent history, but on examination, you note palmar erythema, multiple spider naevi, significant abdominal distention with shifting dullness and bilaterally reduced air entry to the lung bases. An x-ray confirms small bilateral pleural effusions. 

Given the likely cause of the pleural effusions, which of the following is the most appropriate management strategy for them? 

Select the SINGLE most appropriate option from the list below. Select ONE option only.