The Covid 19 disease caused by novel corona virus was rst reported in Wuhan, China in December 2019 with 5% patients having severe lung injury. Though this disease primilary presents as the lower respiratory tract infection, multiple digestive manifestation have been reported which are often overlooked. The present case report describes the unusual progression of the Covid 19 disease from pneumonia to a procoagulant state leading to abdominal venous thrombosis and subsequent gut ischemia necessitating emergency laparotomy.

Consumption of a glass of bottle gourd juice is thought to work as a health tonic & part of traditional healthy living practices in India. The juice may in certain circumstances turn bitter with increased levels of the cytotoxic compound called CUCURBITACINS. If the bitter juice is consumed it causes a toxic reaction in the gut leading to abdominal discomfort/pain,vomiting, hematemesis & hypotension which may be rarely fatal, especially in persons with pre existing illness. In the absence of clear cut history regarding the consumption of the bitter gourd juice & the initiation of symptoms ,the differential diagnosis for the above symptoms will include diseases causing gastrointestinal bleed with hypotension and/or shock. We report a case of bitter bottle gourd poisoning presenting with abdominal symptoms, hematemesis and shock and with an initial differential diagnosis of septicaem a with septic shock & multi organ involvement. We conduct a literature review & ponder the various differential diagnoses of this clinical scenario.