An unusual cause of obscure gastrointestinal bleeding in a patient with cirrhosis

A 59-year-old woman with hepatitis C virus-related cirrhosis and oesophageal varices underwent laparotomy and right salpingo-oophorectomy for right ovarian fibroma, 6 months prior to this admission. The pre-operative CT scan, for the assessment of the ovarian fibroma revealed, incidentally, subcutaneous umbilical collateral vessels (figure 1A). A ventral hernia developed 3 months after the surgery, and the size of the hernia sac enlarged progressively. The patient was admitted because she passed bloody stools the day before admission. On admission, the physical examination revealed collateral veins and a soft bulging mass in the lower abdomen. The laboratory examination revealed: haemoglobin, 7.1 gm/dl …