Abdominal Distension

A 44-year-old woman presented with progressive abdominal distention for 5 days followed by fever and loose stool for 3 days. On the day of admission, she experienced breathlessness and generalize abdominal pain too. She had a past history of hospitalizations due to vomiting of blood. On examination, the patient was conscious but lethargic. She appeared to be pale, breathless and in pain. There was no jaundice. She had leukonychia, palmar erythema and loss of axillary hair. Abdominal examination revealed a uniformly tense and distended abdomen with positive shifting dullness and fluid thrill. The distended abdomen did not allow for a proper palpation of any masses. Abdominal X-ray excluded bowel perforation. Peritoneal tapping was done and a total of 3.7L of straw coloured ascitic fluid was drained.

  1. What is a likely cause of her abdominal distension?
  2. What is a likely reason for her pallor?
  3. What is a likely reason for her abdominal pain?
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