Massive gastric dilation caused by gastric outlet obstruction in the setting of peptic ulcer disease—A case report

BACKGROUND: The prevalence of Peptic Ulcer Disease has decreased as did its elective surgical treatment, however its complications continue to occur. Gastric Outlet Obstruction is the least frequent complication of Peptic Ulcer disease. CASE SUMMARY: In this report, we present a case of massive gastric dilation due to gastric outlet obstruction, that needed emergency surgery due to perforation. A subtotal gastrectomy with a Billroth II reconstruction was performed. DISCUSSION: Usually non-operative management is tried first, with medical therapy and endoscopic dilation. Emergent surgery is rarely needed, but in this patient, despite trying to optimize his condition first, the ulcer perforation precipitated surgical management. CONCLUSION: Although Gastric Outlet Obstruction is the least frequent complication of Peptic Ulcer Disease and usually non-operative treatment is tried first, surgery may be necessary.