Spontaneous haemoperitoneum caused by ruptured varices in a patient with non-cirrhotic portal hypertension

OBJECTIVE: To report the case of a patient with a spontaneous, massive and fatal intraperitoneal haemorrhage from porto-systemic collaterals, caused by portal hypertension. We also review the cases of 18 cirrhotic patients with spontaneous bleeding of intraperitoneal varices and no previous abdominal surgery reported in the literature. PATIENT: A 21-year-old man with nodular regenerative hyperplasia, who had not undergone any previous surgery and who had large oesophageal varices diagnosed 3 years previously. CONCLUSION: To our knowledge, this is the first case of spontaneous intra-abdominal bleeding from collateral vessels in a non-cirrhotic patient.