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Acute massive gastric dilatation (AMGD) after feeding jejunostomy procedure is often not missed in differential diagnosis due to very low incidence. Fatal complications can occur due to acute massive dilatation. We presents a very rare case of acute massive gastric dilatation on second post-operative day of open feeding jejunostomy due to unknown pathology. Early diagnosis is essential to avoid catastrophic complications and acute massive gastric dilatation should be kept in mind while doing feeding jejunostomy procedure.