title: Constrictive Pericarditis as a Cause of Refractory Ascites.
abstract: We report a 43-year-old man who presented for evaluation of ascites, varices, and hepatosplenomegaly. Initial labs were notable for normal platelets, mild liver synthetic dysfunction, and disproportionately elevated alkaline phosphatase. He was presumed to have underlying cirrhosis, and diuresis was attempted without success. A transjugular liver biopsy showed marked sinusoidal dilation without cirrhosis. Diagnostic paracentesis revealed fluid studies suggestive of cardiac ascites. Further cardiac evaluation confirmed constrictive pericarditis. The case highlights the importance of considering a broad differential in the evaluation of ascites.
authors.affiliation: Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Zurabi
authors.initials: Z
authors.lastname: Lominadze
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Leila
authors.initials: L
authors.lastname: Kia
authors.affiliation: Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Sanjiv
authors.initials: S
authors.lastname: Shah
authors.affiliation: Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Keyur
authors.initials: K
authors.lastname: Parekh
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL ; Division of Organ Transplantation, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Josh
authors.initials: J
authors.lastname: Levitsky