What finding would argue in favor of ascites in a patient with increasing abdominal girth?

The finding that supports the presence of ascites in a patient with increasing abdominal girth is characterized by tympany that changes location when the patient changes position. Ascites, which is the accumulation of fluid in the abdominal cavity, typically presents with specific physical examination findings. When a patient is supine, fluid in the abdomen will collect in the most dependent areas, leading to dullness when percussing over those regions. As the patient shifts positions, such as moving from supine to lateral, the fluid redistributes, and tympany can become apparent over areas that were previously dull. This shifting of tympany indicates that the fluid is present and that it is mobile, which is consistent with ascitic fluid.

In contrast, bilateral flank tympany or centrally dullness when supine may suggest other conditions, such as large-volume fluid collections or peritoneal effusion, but these findings alone are less definitive for ascites compared to the shifting tympany. Dullness remaining despite change in position would indicate a more fixed or large volume of fluid that does not shift, which does not favor the diagnosis of ascites. In essence, the change in percussion note with position provides strong evidence for the presence of free fluid in the