A boy with abdominal Burkitt's lymphoma developed rectal bleeding, abdominal distension, pain, and fever three weeks after diagnosis. Imaging studies revealed a necrotic tumor mass allowing a fistulous pathway from the ileum to the proximal colon. A laparotomy was performed, with resection of the large necrotic tumor. The child recovered, and has had no further evidence of Burkitt's disease. The radiological evaluation performed in this case ensured proper medical management and surgical intervention during a life-threatening event. the possibility of bowel perforation as a complication of therapy for abdominal lymphoma must be recognized.