Background: Spontaneous stomach rupture was described as an original entity in 1818. Ever since it has been sporadically reported in literature and considered a potentially lethal cause of acute abdomen.
Case report: We report a case of stomach rupture in a morbidly obese female patient associated with giant epigastric hernia. The onset of symptoms and clinical presentation of the patient were non-specific. Intraoperative
findings included a longitudinal rupture along minor curvature, not associated with other pathology. Despite adequate support, the patient died on 18th postoperative day. Related literature is reviewed.
Conclusion: Spontaneous stomach rupture has been described in association with bulimic attacks, excessive consumption of baking soda and accidental oxygen insufflation. It carries increased mortality rate compared to
postoperative mortality due to chronic peptic ulcer perforation. This may be attributed to the fact that at the time of rupture the stomach is overfilled and that it takes place in patients with severe co-morbid conditions.

Keywords: spontaneous stomach rupture, morbid obesity, epigastric hernia