Objective To study gastric rupture, a progressive,rnrapid and high mortality condition, caused by acute rngastric distention (GRAGD) and its appropriate rndiagnosis and treatment.rnMethods The etiology, pathology, clinical rnmanifestations and expeniences in 3 children with rnGRAGD were reviewed.rnResults Case 1: After diagnosising GRAGD and rnstabilizing her shock with massive fluid replacement,rngastrostomy was performed. Her postoparative course rnwas uneventful because of fasting, suction, fluid rninfusion, correction of acidosis and supporting rnnatrition. Case 2: After diagnosising gastric distention rnwhich subsided With conservative therapy for 9 days,rnshe suddanly had gastric rupture when she had not rneaten for 6 days. She died of shock and had no rnchence for surgery. Case 3: The patient had sudden rnabdominal pain, distention end vomitting with severe rnshlock for 4 days. Emergency surgery found gastric rnrupture and the method was the same as Case 1. The rnpatient survived but has brain impairment. Case 1 and rn3 showed multifiocal transmural necrosis.rnConclusions Sptoms like overeating, bulimia,rnchanges in kind of food, X-ray showing large distended rnstomach and massive pneumoperitoneum were seen rnafter pastric rupture and can help to diagnose this rncondition. Clinical course of gastric dislention with toxic rnshock progresses rapidly, hewever subsequent gastric rnrupture exacerbates the shock and makes the rntreatment difficult treatment.It is extremely important rnthat a laparotomy he performed at once after stabilizing rnshock with massive fluid replacement. Postoperative rnnutritional support and fluid replacement will increase rnsurvival. It is very important that when gastric rndistenition disappears after conservative therapy,the rndoctor should assess carefully whether the gastric wall rnrecovery is under way by using effective methods of rnexamination.