Intraperitoneal haemorrhage from anterior abdominal wall varices

Abstract

Summary: Patients with oesophageal varices frequently present with gastrointestinal haemorrhage but bleeding from varices at other sites is rare. We present a patient with hepatitis C-induced cirrhosis and partial portal vein occlusion who developed spontaneous haemorrhage from anterior abdominal wall varices into the rectus abdominus muscle and peritoneal cavity.

External Hemorrhage from a Portacaval Anastomosis in a Patient with Liver Cirrhosis

“…Portal hypertension is defined as a pressure above 12 mm Hg in the portal vein, leading to portosystemic shunts in several anatomic regions. The most common sites are between the gastroesophageal vein and azygos/hemiazygos system, between the hemorrhoidal and internal iliac veins, and between the umbilical and periumbilical veins draining into the epigastric veins of the anterior abdominal wall [ 1 , 2 ].…”

Ectopic Varices: A Primer

“…If a recanalized paraumbilical vein ruptures within the falciform ligament, life-threatening intraperitoneal bleeding can occur. 36 In these cases, clinical suspicion and diagnosis may be difficult to make when bleeding occurs outside the gastrointestinal tract. Bleeding into the abdominal cavity should be considered in cirrhotic patients with hypotension and unexplained blood loss.…”

Massive umbilical variceal bleeding in alcoholic cirrhosis and its long‐term successful treatment by rubber band ligation

“…Severe portal hypertension can lead to the recanalization of umbilical and paraumbilical veins. Umbilical varices are not common and generally asymptomatic, which are usually discovered incidentally on computed tomography (CT) and ultrasound, but their rupture results in hemoperitoneum . External bleeding from umbilical varix is very rare, which have been reported to be managed by various therapeutic modalities such as omphalectomy, embolization, laparoscopic clipping and transjugular intrahepatic portosystemic shunt (TIPS).…”

“…Umbilical varices are not common and generally asymptomatic, which are usually discovered incidentally on computed tomography (CT) and ultrasound, but their rupture results in hemoperitoneum. 2,3 External bleeding from umbilical varix is very rare, which have been reported to be managed by various therapeutic modalities such as omphalectomy, 4 embolization, 5,6 laparoscopic clipping 7,8 and transjugular intrahepatic portosystemic shunt (TIPS) [9][10][11] . However, the application of laparoscopy and TIPS depends on the patient's condition, the doctor's experience and the usefulness of the equipment.…”