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A rare cause of ascites
  1. Muhammad Afzal,
  2. Penny Neild
  1. Department of Gastroenterology, St George's Hospital, London, UK
  1. Correspondence to Dr Muhammad Afzal, Department of Gastroenterology, St George's Hospital, Blackshaw Road, London SW17 0QT, UK; mafzalmrcp{at}yahoo.co.uk

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Clinical presentation

A 33-year-old man presented with a 2-week history of abdominal pain, vomiting and weight loss. There was no history of fever, diarrhoea or travel. In his medical history, he had had end-stage renal failure secondary to malignant hypertension and had been on peritoneal dialysis for 8 years before having a cadaveric renal transplant in 2008. He was taking tacrolimus and prednisolone since his renal transplant.

On examination he was afebrile, but tachycardic with a heart rate of 110 per minute and blood pressure of 90/70 mm Hg. Abdominal examination revealed normal bowel sounds and moderate ascites. A diagnostic tap of ascites …

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