The cause of our patient's nonocclusive thrombus in the small vessel of gallbladder wall, the SMA as well as some of its distal branches remains unclear. Repeated floods of catecholamines by METH abuse lead to acute accelerated hypertension, tachycardia, and intense vasoconstriction. The arterial walls are now subject to severe shearing forces, which resulted in intimal injury, consequent vessel thrombosis, and aortic dissection.