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A middle-aged man with systemic lupus erythematosus (SLE) presented with acute onset of abdominal pain associated with diarrhoea and vomiting. The patient was haemodynamically stable and the hydration was maintained. The patient also had intermittent urgency and a sense of incomplete urinary bladder emptying. Emergency multidetector CT scans of the abdomen and pelvis revealed moderate to severe wall oedema and mucosal swelling of the small bowel (figure 1) and entire length of the large colon (figure 2). There was moderate to severe stranding and increased vascularity within the mesentery and the mesocolon (figures 1 and 2). The major abdominal vessels, including the mesenteric arteries and veins, however, were patent.