Acute gastric dilatation generally occurs as a postoperative or postanesthetic complication. This rare condition also occurs after trauma and in patients with body casts. Anorexia nervosa and bulimia nervosa have been described to be associated with acute gastric dilatation and duodenal obstruction. A case of acute gastric dilatation with duodenal obstruction accompanying acute pancreatitis or elevated serum pancreatic enzymes in anorexia nervosa or bulimia nervosa has rarely been reported in the literature, but never in Korea. Recently, we experienced the case in a 23-year-old woman. We report this rare condition with a review of the literatures. (Kor J Gastroenterol 2000;36:245 - 249)