Porphyrias are rare, genetically inherited group of disorders. The most common disorder among acute porphyrias are the acute intermittent porphyria, which occurs due a defect of the enzyme porphobilinogendeaminase, presenting commonly with a triad of symptoms: visceral abdominal pain, diagnostic confusion and delay, leading to multiple investigations, unnecessary treatment interventions, high cost of management, with frequent visits to emergency room and a prolonged ward stay. A more for years as "Functional", Malingerers, Mentally ill. In underdeveloped countries, owing to limited investigative procedures, costly laboratory investigations, poor socio-economic status, much reliance on clinical judgment is required.