Normal gastric emptying is a complex mechanism involving coordinated gastric and duodenal muscular contractions modulated by the autonomic nervous system, myenteric and submucosal plexus, interstitial cells of Cajal (ICC), which are divided into myenteric (ICC-MY) and intramuscular ICC (ICC-IM), and the central nervous system. Gastroparesis can result from a lesion at any level of these physiological processes.

In 1997, a 47 year old man was referred to Louis Mourier Hospital with longstanding symptoms of gastroparesis associated with pyrosis and regurgitations with progressive worsening. Physical examination and usual laboratory results were normal. An autoimmune study was negative for every antibody, including anti-HU, anti-YO, anti-RI, antinuclear, anti-RO, anti-SSA, anti-intrinsic factor, antigliadin, antiendomysium, anticardiolipid, antithyroperoxidase, and antithyroglobulin antibodies. Serum antibodies of the herpes class virus, Epstein-Barr virus, and cytomegalovirus were in favour of past infections. Upper gastrointestinal endoscopy with histological analysis was normal. Gastric scintigraphy showed …