Lastly, large volume paracentesis (with or without albumin replacement) under radiological guidance should be used to achieve symptomatic relief, reduce fluid burden and alleviate abdominal distension.15, 45 The presence of spontaneous bacterial peritonitis, although infrequent, should be considered.38 We were unable to find data on the prevalence of peritonitis in PLD patients. This evidence concerns the gene ALB and peritonitis.