Acute gastric dilation leading to ischemia of the stomach is an under-diagnosed and potentially fatal event. Without proper and timely diagnosis and treatment, gastric perforation, hemorrhage, and other serious complications can occur. We report a case of a 69 yr old postmenopausal woman having a history of irritable bowel syndrome(alternate type) presented with a right breast lump and undergone right modified radical mastectomy develop acute gastric dilatation(AGD) on the second postoperative day which was confirmed by ultrasonography.

Postoperative gastric dilatation is usually seen in surgeries were bowel is handled intraoperatively . The patient in our case was not at an increased risk for post operative AGD since imaging studies did not reveal any evidence of gastric or bowel obstruction. Also, pre-surgery USG finding was normal The only concern was about irritable bowel syndrome but there is no literature showing any co- relation between these two. Opioids like fentanyl and tramadol were for induction and post operative pain management and Nitrous oxide for maintainence of anaesthesia.With this case report we intend to draw attention towards massive acute gastric dilatation in a surgery not at risk for it.