An 87-year-old female patient with history of hypertension, dyslipidemia and Parkinson disease, enters in the emergency room with complaints of dyspnea after vomiting food content. The patient had undergone terminal colostomy due to a rectovaginal fistula, three years ago.

Laboratory evaluation showed infiltration in the right lower pulmonary lobe, hypoxemic respiratory failure and hyperlacticaemia. Aspiration pneumonia was assumed, and the patient was admitted to the internal medicine service where she started empirical antibiotic therapy with amoxicillin and clavulanic acid. A nasogastric tube was placed due to persistent vomiting with food intolerance. During hospitalization, the patient had complained of abdominal pain with maintained drainage of fecaloid content, experienced worsening of inflammatory parameters. In the suspicion of an occlusive intestinal condition, an abdominopelvic computerized tomography was performed, which showed an exuberant gastric distension with enlargement of the stomach to the pelvis (Figure 1). Upper digestive endoscopy revealed an antrum stenosis (Figure 2) and the presence of stasis content with areas of ulcerated mucosa (Figure 3). Patient's clinical condition worsened, and she died one week later.