A 42-Year-Old Man with Swollen Legs Shows Up at the Office

A 42-year-old man with swollen legs shows up at the office. Along with a 7 kg (15.4 lb) weight gain, he has also had progressive abdominal distension and eye yellowing during the past three weeks. The patient has previously been taken to the hospital for intoxication and seizures and consumes at least 8 beers every day. He denies using drugs intravenously or smoking. Vital indicators are in the expected range. There are palmar erythema, spider angiomas, and scleral icterus. A normal heartbeat and rhythm can be heard during cardiac auscultation, and there is no jugular venous distension. Breathing noises are typical. A fluid wave can be easily triggered due to the abdomen's widespread enlargement. There is bilateral lower extremity pinning edema. Which of the following pathophysiologic changes is most likely present in this patient?

A) A
B) B
C) C
D) D
E) E