Abstract
INTRODUCTION: Acute abdomen during early pregnancy poses a diagnostic challenge, especially in patients with underlying chronic gastrointestinal diseases. CASE REPORT: A 36-year-old woman with Crohn’s disease and a confirmed 6-week intrauterine pregnancy presented with diffuse abdominal pain. Initial investigations, including MRI and ultrasound, were inconclusive. Diagnostic laparoscopy revealed malrotation of the large bowel and a perforated appendix, which was successfully managed with appendectomy and lavage. CONCLUSION: This case highlights the diagnostic complexity of abdominal pain in early pregnancy, particularly in patients with Crohn’s disease and anatomic variations such as intestinal malrotation.