Acute gastric dilatation occurred in five children suffering from parental neglect of deprivational dwarfism. Pathogenesis of acute gastric atony in the deprived child is related to structural and functional changes in the stomach due to chronic starvation, and the acute ingestion of a large meal. Radiographic recognition of acute gastric dilatation in a child who is not postoperative or intoxicated should suggest the presence of chronic starvation and child neglect.