Ascites in CML - A Rare Extramedullary Manifestation

A 23 years female presented with history of generalised weakness and easy fatigability of 3 months duration, pain and distension of abdomen since 15 days and difficulty in breathing since 3 days due to abdominal distension. .She had no history of fever, cough, jaundice, decreased urine output, chest pain, palpitations or any bleeding tendency. On physical examination, patient was emaciated, afebrile, pulse was 90/min, regular, blood pressure was 110/70 mmHg, tachypnoeic with respiratory rate of 24/min and Spo2 was 92 % on room air. She was pale. No other positive findings like icterus, cyanosis, oedema feet, lymphadenopathy, petechiae, purpura or ecchymotic patches, sternal tenderness or any signs of liver cell failure were observed. Abdominal examination revealed tense ascites and splenomegaly about 20 cms extending upto umbilicus. Normal peristaltic sounds were audible. Rest of the systemic examination was within normal limits.