Acute gastric dilatation associated with multiple trauma.

More than 30 years ago Dr. Henry K. Beecher advocated gastric emptying on all war casualties prior to the administration of anesthesia. The primary reason was to avoid aspiration of gastric contents, but a secondary one was the interference with circulation that seemed to occur with gastric distention.1 Since World War II there have been reports in the literature of acute gastric dilatation following application of plaster jackets or hip spicas (body cast syndrome) and after minor surgery such as dilatation and curettage and appendectomy.2 There have also been reports of acute gastric dilatation following blunt abdominal trauma and trauma to the extremities." These reports have been concerned with patients not requiring surgery. In 1979 a report in the Norwegian literature described a case of acute gastric dilatation following trauma, which resulted in exploratory laparotomy.4 If this dilatation had been correctly diagnosed, laparotomy could have been avoided. The case presented in this article is one of multiple trauma with acute gastric dilatation complicating anesthesia and the surgical procedure.