A 75-year-old male patient presented with respiratory distress after a road traffic accident. On examination, he was dyspneic. Computed tomography (CT) revealed features suggestive of massive hemothorax. He underwent an urgent open thoracotomy following which his condition improved. On the third day of hospitalization, he developed acute onset abdominal distension. The percussion note over the abdomen was tympanic, and bowel sounds were sluggish. Abdominal X-ray revealed dilated bowel loops with multiple air–fluid levels. The serum sodium level was 139 mEq/L, and the serum potassium level was 2.6 mEq/L.