An unusually large and bulbous stomach is usually considered to be the result of peritoneal effusion if obesity is excluded. Common causes of peritoneal fluid include peritoneal diseases, such as tuberculous peritonitis, primary or metastatic tumors of the peritoneum; liver diseases, such as cirrhosis secondary to spontaneous peritonitis, hepatocellular carcinoma, portal vein thrombosis; renal diseases, such as the presence of nephrotic syndrome leading to massive protein loss, which can result in hypoproteinemia; and intractable heart failure, in which patients can present with massive peritoneal cavity in addition to severe sunken edema of the lower extremities The manifestation of fluid accumulation.