Superior mesenteric artery (SMA) syndrome is a rare clinical disease defined as compression of the third part of the duodenum between the aorta and the SMA. Severe complications of SMA syndrome include acute gastric dilatation which is uncommon but potentially fatal and requires immediate intervention. This report describes a 29-year-old woman with SMA syndrome complicated by acute gastric dilatation. It was diagnosed by computerized tomography. The patient had a history of treatment of bulimia nervosa but defaulted 3 months ago. She presented with severe abdominal distension and extreme abdominal pain due to massive gastric dilatation after an eating binge. Gastric decompression was successful with a modified gastric lavage tube with additional large holes at the tip.
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