The presence of ascites is a classic sign of?

• A. CHF
• B. Hernia
• C. Bowel obstruction
• D. Paralytic ileus

Answer: (A)

Fluid accumulation in the peritoneal cavity from elevated venous pressure and sodium–water retention points to heart failure, especially when right-sided or biventricle involvement is present. In congestive heart failure, venous pressures rise and the liver and systemic venous beds become congested, pushing fluid out of the vessels into the abdominal cavity, producing ascites. This makes ascites a signal of fluid overload and poor venous return that aligns with heart failure.

Hernia presents as a localized bulge or protrusion of tissue through a weakness, not free fluid in the abdomen. Bowel obstruction or paralytic ileus causes abdominal distension from gas and fluid within the intestines and altered bowel sounds, but they do not produce free peritoneal fluid like ascites. So among the options, ascites best fits the pattern seen with congestive heart failure.