Abstract
BACKGROUND: Acute mesenteric ischemia is a life-threatening disease. Intrasplenic gas is an extremely rare finding in such cases. CASE SUMMARY: We report a case of a 79-year-old woman with a history of end-stage renal disease on hemodialysis for approximately 20 years, type 2 diabetes mellitus, and atrial fibrillation who presented with two days of epigastric pain. A computed tomography scan of the abdomen revealed intraperitoneal free air and significant intrasplenic gas. Laparoscopy revealed diffuse intestinal gangrene, and acute superior mesenteric ischemia was diagnosed. The patient died within 24 hours owing to profound shock. CONCLUSION: Intrasplenic gas is an extremely rare finding on computed tomography imaging in cases of acute mesenteric ischemia.