Case presentation A 68-year-old woman with a known history of asthma presented to the emergency department complaining of worsening breathlessness over the preceding two days and gradually increasing abdominal girth for one month. She also reported poor appetite and an unintentional weight loss of about 15 pounds during this period. She denied associated fever, cough, or chest pain.
Physical examination The patient appeared cachectic and mildly tachypneic Oxygen saturation: 88% on room air Distended abdomen with a fluid wave Bilateral lower-extremity edema Reduced breath sounds bilaterally, more pronounced on the right side Chest X-ray (Figure 1): Large right-sided pleural effusion Figure 1 . Chest radiography showing a large right pleural effusion with associated atelectasis CT of the chest, abdomen, and pelvis (Figure 2) Diffuse peritoneal nodularity Omental thickening Both ovaries…
