| Summary: | Introduction Pneumatosis intestinalis is usually considered as a benign condition. Here we report the association of this condition with mesenteric vein thrombosis leading to gangrenous bowel which, to our best knowledge, is the first reported association. Case Presentation The patient was a 71-year old Iranian smoker man, who was diagnosed with pneumatosis intestinalis for 11 months and then developed the abdominal pain which was confirmed to be due to the mesenteric vein thrombosis complicated by bowel gangrene. Discussion Although pneumatosis intestinalis is not usually threatening in adults, its new onset in the abdomen of these patients should prompt the complications such as mesenteric vein thrombosis.
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