Abstract
We present the case of a male in his 50s who developed sudden abdominal pain two days after testing positive for coronavirus disease 2019 (COVID-19) and was brought to the emergency department in shock. An emergency laparotomy revealed intraperitoneal hemorrhage due to spontaneous rupture of the right gastroepiploic artery. Histopathological examination revealed necrotizing vasculitis, while systemic causes were excluded. The case was diagnosed as abdominal single-organ vasculitis (SOV) likely triggered by COVID-19. This rare presentation highlights the importance of considering SOV in COVID-19 patients presenting with acute abdomen, as early recognition and intervention are critical to avoid life-threatening hemorrhage.