Question: A 20-year-old man was referred for increasing abdominal girth. Three years previously, he developed voluminous milky diarrhea and was diagnosed with protein-losing enteropathy. His diarrhea subsequently resolved, but he then developed abdominal distention. An upper endoscopy and colonoscopy performed at another facility were reported to be normal. He had no other significant medical, surgical, or family history. On physical examination, the abdomen was distended with striae and shifting dullness.