The main reasons for an elderly person to have a distended stomach and then pass away include the following: First, it is considered to be due to rupture of abdominal organs, which causes hemorrhage and then leads to sudden death. Possible reasons include rupture of substantial organs such as liver or spleen, which causes hemorrhage and leads to sudden death of the patient. Secondly, it is considered that the death is caused by electrolyte disturbance due to intestinal obstruction, which leads to slow intestinal peristalsis and abdominal distension, and affects electrolyte absorption, leading to electrolyte disturbance and death. The third aspect is that hypoproteinemia or cirrhotic ascites may cause abdominal distension and metabolic disorders, which may lead to death. There are many possible causes, which need to be combined with the specific condition and relevant tests to determine the specific cause.