Abstract
Duchenne muscular dystrophy (DMD) is a progressive neuromuscular disorder associated with degeneration of both skeletal and smooth muscles. Gastrointestinal (GI) complications, including gastroparesis and gastric dilatation, are underrecognized but potentially life-threatening. We present the case of a 16-year-old patient with DMD who developed acute gastric dilatation secondary to gastroparesis. Imaging revealed severe gastric dilatation and organoaxial gastric volvulus. The patient required nasogastric decompression, prokinetic therapy, endoscopic transpyloric tube placement, and eventually gastrojejunostomy for enteral feeding. After 15 months of nutritional and pharmacologic support, the patient transitioned to gastric and later oral feeding with good tolerance. GI manifestations in DMD stem from smooth muscle atrophy, altered motility, and delayed gastric emptying. The literature review identified similar cases with varying presentations and treatments. Gastroparesis may be compounded with constipation, increasing the risk of complications. DMD patients may present with acute gastric dilatation as a consequence of progressive GI dysfunction. Early recognition and intervention with decompression, prokinetics, and enteral support are critical to improve outcomes.