Acute massive gastric dilatation with multiple organ sequelae: A case report

We present a case of acute massive gastric dilatation in a 16-year-old patient with previous gastric fundoplication, who developed unusual multiple organ sequelae which have seldom been described in this context. The patient presented with acute massive gastric dilatation, and subsequently developed acute pancreatitis, superior mesenteric artery syndrome, the nutcracker phenomenon, and after resolution developed acute bowel obstruction. He had adhesiolysis and gradually returned to baseline with prokinetics and dietary interventions. We discuss the sequence of events as they unfolded and a presumed mechanism for this unusual course. This case demonstrates several sequelae of an acute massive gastric dilatation as a late complication of fundoplication, which physicians should keep in mind when treating such patients.