Severe acute gastric dilatation causing respiratory failure.

Severe acute gastric dilatation occurring in the absence of bowel obstruction is uncommon. We report acute gastric dilatation developing postoperatively in a 79-year-old man, culminating in respiratory failure. On the third postoperative day following bilateral inguinal hernia repair, he developed abdominal distension with absent bowel sounds. Abdominal radiograph showed a grossly distended gastric shadow and small bowel dilatation. The patient's oxygen saturation then deteriorated suddenly and severely, necessitating intubation. He recovered well with conservative measures.