A 55-year-old woman exhibited lack of efficacy while receiving furosemide and spironolactone for ascites [routes and dosages not stated].The man, who had a history of cirrhosis secondary to non-alcoholic steatohepatitis and recurrent pancreatitis presented to clinic with recurrent ascites, abdominal fullness, leg swelling and shortness of breath. She received furosemide and spironolactone; however, her symptoms did not relive.Laboratory investigation revealed normal vital signs with sodium level of 129 mmol/L, pro-brain natriuretic peptide of 637 pg/mL, total bilirubin of 3.9 mg/dL and alkaline phosphatase of 504 units/L. The woman underwent paracentesis, and 4.7L of straw-colored fluid was removed. Fluid analysis demonstrated signet ring vacuolated cells without any evidences of malignant cells. Subsequently, after removal of fluid, her symptoms improved.