Acute Pancreatitis and Severe Gastric Dilation After Suspected Scorpion Envenomation: A Case Report

Scorpion envenomation is an uncommon cause of acute pancreatitis in the United States, with systemic manifestations more commonly reported with medically significant scorpion species. A 26-year-old non-verbal man with autism presented with three days of abdominal pain, posturing, drooling, vomiting, and visible distress after suspected household scorpion exposure in Georgia. Laboratory testing revealed leukocytosis with markedly elevated lipase and amylase. CT showed acute pancreatitis with severe gastric and duodenal dilation without mechanical obstruction. Follow-up imaging demonstrated resolution of gastric distension but persistent pancreatitis-related inflammation. Esophagogastroduodenoscopy revealed retained gastric contents consistent with gastroparesis, without pyloric stenosis or gastric outlet obstruction. Common etiologies were not supported by the available evaluation. The patient improved with supportive management, including bowel rest, intravenous fluids, gastric decompression, analgesia, electrolyte correction, cautious advancement of diet, and metoclopramide. This case highlights suspected scorpion envenomation as a rare possible trigger of acute pancreatitis with severe gastric dilation and gastroparesis.