Q. A 58-year-old man with a history of alcohol-related cirrhosis presents to the primary care clinic with complaints of increasing abdominal girth and discomfort. He has been diagnosed with ascites and is currently on spironolactone and furosemide. Despite initial improvement, he now reports progressive abdominal distension and has recently developed a low-grade fever and abdominal tenderness.
Physical examination reveals marked ascites and diffuse abdominal tenderness without rebound or guarding.
Laboratory tests show a worsening of liver function tests and renal function. A diagnostic paracentesis is performed, and the analysis of ascitic fluid is pending.
Given the patient’s history of cirrhosis with ascites and current presentation, what is the most common complication of ascites in this setting?