A 28-year-old man was referred as an emergency case from a regimental medical clinic to the surgical unit of the Armed Forces Hospital, Muscat, Oman, in 2016 with complaints of severe vomiting, epigastric pain and bloating of two days' duration. The patient gave a history of abdominal bloating associated with early satiety, postprandial pain and occasional vomiting over the past year and a half. There was no other significant medical or surgical history. Clinically, the patient was underweight and pale with a body mass index of 17 kg/m2 . An abdominal examination revealed upper abdominal tenderness and distention. The findings of initial blood tests and laboratory investigations were unremarkable. An ultrasound of the abdomen performed two days prior at the previous institution demonstrated no sonographical abnormalities.