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A 60-year-old woman with a history of allogeneic stem cell transplantation in 2021 for acute myeloid leukaemia was admitted to our intensive care unit (ICU) with pneumococcal septic shock. She initially responded well to treatment with meropenem. However, during her ICU stay, she experienced secondary clinical deterioration requiring renewed vasopressor support. CT revealed marked thickening of the gastric fundal wall (figure 1) and splenic infarction. To further assess the gastric findings, oesophagogastroscopy was performed, revealing a necrotic area in the gastric fundus (figure 2). Suspecting gastric ischaemia, surgical resection of the gastric fundus was undertaken, along with splenectomy.