On presentation, the patient’s vitals were as follows: BP, 90/54 mm Hg; heart rate, 112/min; temperature, 38.4°C; respiratory rate, 28/min; and oxygen saturation, 94% on room air. Physical examination revealed an ill-appearing man. His abdomen was distended with diffuse tenderness and guarding. Pertinent laboratory values were as follows: WBC count, 17,400/μL with 28% bands; hemoglobin, 8.7 g/dL; platelet count, 85,000/mmol; prothrombin time/international normalized ratio, 2.1; creatinine, 3.8 mg/dL; and total bilirubin, 4.8 mg/dL. Bedside ultrasonography was used to verify the presence of ascitic fluid and to identify the best entry point for paracentesis (Video 1).