May i ask you about a case of 87 year old male patient not diabetic nor hypertensive but heavy smoker for over 60 years presented with abdominal pain of acute onset , progressive course not referred and increased by movement . on examination the patient has tenderness in flanks with bilateral shifting dullness U/S revealed moderate ascites for which ascitic fluid analysis was taken revealing tlc count of 1600 ( 80% lymphocytes ) Ascitic fluid ADH was high suggestive of tb Tb test was negative Ct chest and abdomen showed fine apical reticulations of chest mostly post inflammatory Bulky head of pancreas with ill_defined non enhancing area of hypodensity encircling CBD with ( double duct sign ) and proximal dilatation of CBD as well as jntra and extra hepatic radicles dilatation Marked pelvi_abdiminal ascites. Bilirubin levels are normal Cytology for ascetic fluid came negative for TB. Echo findings were normal. The patient is now having dyspnea with marked ascites that needed tapping. what would be the next step to evaluate this patient?