21st April 2024

A 48-year-old female presents with a 6-week history of abdominal swelling and discomfort

A 48-year-old female presents with a 6-week history of abdominal swelling and discomfort. She also reports feeling generally tired. She has a BMI of 32 and a PMH of hypothyroidism and depression. On questioning, she reports drinking 3 bottles of wine per week. On examination, she is pale and has clear clinical evidence of ascites but no other stigmata of chronic liver disease. An ascitic tap demonstrates raised lymphocytes (400/µ) and a serum-ascites albumin gradient (SAAG) of <11g/L.

What is the most likely diagnosis?

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