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Patients sustaining an injury to the cervical spine at C3/4 level, with extensive cord damage, are difficult to manage. The injury is associated with a high mortality. The respiratory complications, including those associated with tracheostomy and intermittent-positive-pressure ventilation, are well recognised. The initial ileus and its management is also well documented. This report describes the development of acute gastric dilatation occurring 4 weeks after injury. The condition is particularly serious as many complications may have been overcome by this time resulting in a false sense of security. Two case histories are described. It is suggested that to a variable degree this complication probably occurs frequently in these patients. The aetiology of the acute gastric dilatation is discussed and recommendations are made (based on experience with one of the cases described), which may reasonably be expected to minimise the development and progress of the condition.

Acute gastric dilatation as a relatively late complication of tetraplegia due to very high cervical cord injury