We present the case of an elderly patient, who had orthopaedic surgery and suffered in the early post-operative period an idiopathic gastric partial necrosis. We reviewed the literature and it is an extraordinarily infrequent entity. Partial resections have already been described in case of limited necrosis, as reported in our case. Prompt diagnosis of idiopathic gastric necrosis and aggressive treatment are mandatory. Further awareness of this strange entity and its risk factors can lead to a quicker diagnosis and higher possibilities of survival for the patient.