PT - JOURNAL ARTICLE AU - Sade Hacking AU - Karl Jackson AU - Robert Johnston AU - Eleanor Grogan AU - Rowan Walmsley AU - Leonie Armstrong AU - Joanna Coleman AU - Jennifer Grieve AU - Sarah Robinson AU - Katherine Frew AU - Avinash Aujayeb TI - GIST-related malignant ascites with large-volume paracentesis complicated by myocardial infarction and tumour rupture AID - 10.1136/bmjspcare-2020-002506 DP - 2020 Aug 13 TA - BMJ Supportive & Palliative Care PG - bmjspcare-2020-002506 4099 - http://spcare.bmj.com/content/early/2020/08/12/bmjspcare-2020-002506.short 4100 - http://spcare.bmj.com/content/early/2020/08/12/bmjspcare-2020-002506.full AB - This paper describes a patient with an inoperable gastrointestinal stromal tumour with moderate volume malignant ascites. A large-volume paracentesis caused haemodynamic instability and a myocardial infarction. An indwelling right-sided peritoneal catheter was inserted following further ascites build-up. The patient experienced spontaneous acute rupture of tumour and subsequent loculated ascites. An additional second catheter was inserted to the left side of the abdomen following reaccumulation of ascites following liquefaction of cyst contents and successful one-off drainage on the left side of abdomen. This is the first case report of a patient with two indwelling catheters: we describe learning points pertaining to those as well as the rupture of gastrointestinal stromal tumours. Haemodynamic instability after paracentesis in malignant-related ascites has also not been described