Patient Hx: Liver & Ascites

Alcohol intake Quantity and duration Has ascites diminished/resolved intermittently in relation to abstinence from alcohol? Risk factors for viral hepatitis IV drug use Tattoos Acupuncture Sexual history Travel history, where born Family history (Wilson's disease, hemochromatosis) How rapidly has the increase in abdominal girth occurred? Does the patient have a history of cirrhosis? Symptoms suggestive of malignancy? Prior history of cancer Associated abdominal pain History of long-standing cirrhosis followed by abrupt development of ascites: consider hepatocellular carcinoma History of cardio-pulmonary disease Congestive heart failure (CHF) Cardiomyopathy Constrictive pericarditis Cor pulmonal Symptoms of infections Consider spontaneous bacterial peritonitis (SBP) in patient with ascites and fever or abdominal discomfort History of tuberculosis - more likely in patient with alcoholism, poor nutritional status, or recent immigration to the US HIV infection (more commonly have small amount of ascites incidentally detected)