A 55-Year-Old Man Comes to the Office Due to Progressive

A 55-year-old man comes to the office due to progressive abdominal distension for the past 2 months.  He reports that his abdomen has become so large that his clothes no longer fit.  Temperature is 37.5 C (99.5 F) , blood pressure is 152/87 mm Hg, pulse is 80/min, and respirations are 18/min.  The abdomen is grossly enlarged and nontender.  Shifting dullness is present.  Trace pitting edema is identified in the bilateral lower extremities.  Paracentesis reveals bloody ascitic fluid.  Repeat paracentesis from another site yields similar bloody fluid.  Which of the following is most likely responsible for this patient's presentation?

A) Hepatocellular carcinoma
B) Nephrotic syndrome
C) Portal vein thrombosis
D) Spontaneous bacterial peritonitis
E) Tuberculosis

Correct Answer:

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