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 UNUSUAL CASE
Year : 2012  |  Volume : 8  |  Issue : 2  |  Page : 54-56

Laparoscopic management of massive spontaneous external haemorrhage from the umbilical varix due to recanalisation of the paraumbilical vein in a patient with 'Child's Class A' liver cirrhosis


Department of General, Gastrointestinal and Laparoscopic Surgery, M.O.S.C Medical College, Kolenchery, Cochin, Kerala, India

Correspondence Address:
Sanoop K Zachariah
Department of Surgical Disciplines, M.O.S.C Medical College, Kolenchery, Cochin, Kerala - 682 311
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-9941.95536

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Spontaneous external haemorrhage from the umbilical varix is an extremely rare complication of portal hypertension. Bleeding is usually into the peritoneal cavity and the treatment involves urgent laparotomy and ligation of the bleeding varices. We describe a cirrhotic 38-year-old man who presented with spontaneous external haemorrhage from the umbilical varix which was successfully managed laparoscopically by in-situ distal clipping and proximal transcutaneous ligation of the recanalised paraumbilical veins. We therefore feel that laparoscopy can be safely and effectively employed to control external haemorrhage from the umbilical varix associated with liver cirrhosis. This novel technique can help avoid a laparotomy and also help preserve the umbilicus.






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