A 45-yr-old male patient developed acute abdominal pain, ileus, and microscopic hematuria with biochemical evidence of pancreatitis and a marked increase in liver alkaline phosphatase; CT demonstrated swelling of the pancreas, bilateral adrenal hemorrhage, and a suggestion of renal hemorrhage. ERCP was negative and renal arterial and venous blood flow normal. A coagulation profile demonstrated the presence of lupus anticoagulant, but tests for anticardiolipin antibodies and collagen vascular diseases were negative. Treatment with corticosteroids and anticoagulation resulted in improvement in clinical and all biochemical indices. Thus, lupus anticoagulant syndrome may masquerade as an acute abdominal illness with multiorgan involvement.