MRCP2-2013
A 57-year-old man comes to the emergency department complaining of worsening shortness of breath. He has a medical history of oesophageal cancer, which was treated six months ago with an oesophagectomy and postoperative chemotherapy and radiotherapy. He has been in remission for three months. Over the past week, his shortness of breath has gotten worse and has been accompanied by abdominal distension. Upon examination, there is dullness to percussion of both lung bases with reduced air entry. His abdomen is tense with shifting dullness, but not very tender. His skin is warm and well perfused. There is no swelling in his legs, and there is no tenderness or pitting oedema. A chest X-ray shows small bilateral pleural effusions. What is the most appropriate treatment to alleviate his shortness of breath?