Acute thrombosis of the celiac trunk is a very uncommon condition, unless diagnosed early can become a life threatening emergency. The clinical presentation is highly variable depending on the extent of the thrombus. We report a case of biliary peritonitis related to an acute thrombosis of the celiac trunk and isolated gangrene of the gall bladder. This case highlights the role of diagnostic laparoscopy in the diagnosis of acute upper abdominal pain. Keywords: Pain abdomen, mesenteric ischaemia, laparoscopy, gall bladder