Gastroparesis: medical or surgical therapy?

It is presented the case of a 63-year-old female patient, who was admitted to the hospital for the first time, because of clinical picture compatible with acute cholecystitis and choledocholithiasis. She underwent cholecystectomy common bile duct (cbd) exploration, and duodenotomy, with the extraction of two stones located in the distal cbd. During her postoperative course, she had been under a great emotional tension, and ten days after her surgical intervention, she developed symptoms and signs of acute gastric dilatation, requiring a second admission. A barium meal and an upper endoscopy revealed gastric dilation, with marked pyloric spasm. Her complaints improved after conservative therapy was instituted. No surgical intervention was necessary. We concluded that the cause of her gastric retention was due to the emotional stress present during her postoperative course, which produced marked pyloric spasm, and not from an organic cause.