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SSK Tepecik Eğitim Hastanesi ¹Pediatri Uzmanı, Adnan Menderes Üniversitesi Tıp Fakültesi ²Pediatri Yardımcı Doçenti, Ege Üniversitesi Tıp Fakültesi ³Pediatri Uzmanı, ⁴Pediatri Doçenti, ⁵Pediatri Profesörü Acute rheumatic fever is the most common acquired heart disease worldwide in the pediatric age group. Since this disease has no specific symptoms or signs, its diagnosis is based primarily on modified Jones criteria. In this report we present a 10-year-old boy who admitted to our pediatric surgery clinic due to acute abdomen and who was diagnosed as acute rheumatic fever on his follow-up. This case illustrates that acute rheumatic fever may present with acute abdomen and that there are still handicaps in its diagnosis, especially if the patient has only one major criterion. We also want to point to the importance of silent carditis, which is diagnosed by color Doppler echocardiography, in the differential diagnosis of acute rheumatic fever. Anahtar Kelimeler : akut romatizmal ateş, akut karın