A Simple Case of Hyponatremia?

A 58-year-old man with a history of hypertension, hepatitis C virus infection previously treated with ledipasvir/sofosbuvir, and cirrhosis (MELD [Model for End Stage Liver Disease] score, 20) presented to an outside hospital with jaundice. His cirrhosis had been complicated by encephalopathy, and several years earlier, he underwent transarterial chemoembolization for hepatocellular carcinoma. He was found to have stigmata of advanced liver disease, including marked ascites and peripheral edema. Computed tomography showed a mass obstructing the biliary tree, and a biliary drain was placed.

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