Starch peritonitis (SP), is a relatively rare surgical complication. T
his together with a puzzling acute clinical pattern, makes diagnosis m
ore difficult. We describe a child who developed a full blown SP, mimi
cking gastric outlet obstruction, 3 weeks after an antireflux procedur
e. We would like to stress the importance of making the correct preope
rative diagnosis, in order to spare the patient an unnecessary operati
on. This may be difficult.