Massive hemoperitoneum due to rupture of a retroperitoneal varix.

Intra-abdominal hemorrhage from ruptured varices is an unusual, life-threatening complication of portal hypertension. We present the case of a 58-year-old man with alcoholic cirrhosis who presented with increasing abdominal girth, hypovolemic shock, and profound anemia due to rupture of a retroperitoneal varix into the peritoneal cavity. The clinical presentation of this rare problem is remarkably consistent among published reports. Early recognition may help the treating physician reduce the likelihood of a catastrophic outcome.