A 52-year-old woman with a history of metastatic gastric cancer presents with gastric outlet obstruction. She undergoes EUS-guided gastrojejunostomy for relief. A month later, she is readmitted with abdominal pain, distension, and new-onset diarrhea. CT shows progression of disease with ascites. Paracentesis improves her abdominal pain, but her diarrhea persists. Upper endoscopy is performed. What is the cause of her diarrhea?
Short gut syndrome because of jejunojejunal anastomosis. Stent migration into the peritoneal space because of ascites. Small-bowel compression because of ascites. Development of a gastrojejunocolic fistula.
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