Background: Acute ischaemia of the small intestine is caused by mesenteric venous thrombosis in 5-15% of patients. The non-specific symptoms frequently lead to a diagnostic delay.
Case description: A 30-year-old pregnant woman presented at the accident and emergency department with progressive abdominal pain, nausea and vomiting. During admission the patient developed signs of peritonitis. Diagnostic laparoscopy revealed a picture of mesenteric venous thrombosis, and we resected 170 cm ischemic small intestine. No underlying cause was identified, apart from the pregnancy. The patient was treated with low-molecular-weight heparin and later gave birth to a healthy child.
Conclusion: If a patient presents with (unexplained) progressive abdominal symptoms and disproportional abdominal pain without peritonitis, the possibility of intestinal ischaemia should be considered during differential diagnosis.