A 14-year-old girl presented to the emergency department with severe abdominal pain. To celebrate her success with school exams, she had a history of binge eating. A non-enhanced computed tomography (CT) scan showed marked dilatation of the stomach (Fig. 1A). After 10 hours, an enhanced CT showed extensive pneumatosis of the gastroduodenal wall and intrahepatic portal vein (Fig. 1B). In addition, we found that the superior mesenteric artery aggravated the degree of duodenal obstruction (Fig. 1C), and the angle between the superior mesenteric artery and the abdominal aorta was sharply decreased (Fig. 2A, B). Meanwhile, the laboratory inspection found a white blood cell count of approximately 38.80 × 10⁹/L and a NEU count of approximately 35.58 × 10⁹/L. An emergency operation revealed that approximately 2/3 of the gastric wall tissue was widely blackened and necrotic (Fig. 2C). The patient eventually underwent a proximal subtotal gastrectomy. Fortunately, the patient improved and was discharged after 2 months.