Sickle cell disease is an inherited autosomal recessive hemoglobinopathy. Acute abdominal pain is the cause of hospitalization in 10% of patients with sickle cell disease and usually occurs during vaso-occlusion or distal tissue ischemia. Determining the etiology of abdominal pain is very difficult in these patients because it is associated with several rare diagnoses, such as pancreatitis and splenic abscess in some patients. We represent a 14-year-old boy with sickle cell disease who was hospitalized due to acute abdominal pain and indicated multiple and scarce disturbances in the spleen and hepatobiliary system.