[Unsatisfactory pain treatment in attacks of acute intermittent porphyria. Vasodilation an alternative if the pain is shown to be the pain of intestinal angina].

Abdominal pain is by far the most serious symptom in attacks of acute intermittent porphyria (AIP). Its cause is unknown. This case suggests visceral ischemia as a possible cause of the abdominal pain. A 31-year-old woman with recurrent bouts died during an attack; the autopsy revealed a 20 cm necrotic gangrene in the ileum. A protracted intestinal vasospasm could have been the immediate cause of death. The question as to whether intestinal angina could be the cause of abdominal pain in acute intermittent porphyria is discussed.