[Extensive intestinal necrosis without obstruction caused by so-called low flow state]

Medical history of a 36 year old woman with severe combined valvular deformities and frequent failure of the circulation inspite of the treatment with digitalis is reported. Impairment of the circulation gradually lead to the so called "low flow state" which resulted in infarction of the small intestine without vascular occlusion. Inspite of the urgent removal of the necrotized segment of the intestine in an extent of 4 metres, the patient died. In connection with the case reported pathologic processes resulting in infarction of the small intestine are discussed. Emphasis is made on the reported less frequently encountered factor and on the effect of digitalis on the circulation of visceral organs.