Question: A 21-year-old woman was referred to our General Surgery Department in South Africa with progressive abdominal distention, abdominal discomfort, and intermittent vomiting over the previous year. She was still managing to pass stools and flatus. There was no history of trauma. She was positive for human immunodeficiency virus (HIV) and taking antiretroviral medications with an admission CD4 count of 554 cells/μL. Past medical history also included cryptococcal meningitis and pulmonary tuberculosis treated 2 years previously.