We experienced a case of 40-year-old woman with liver cirrhosis, who complained of jaundice and abdominal distension. She was diagnosed as having hemoperitoneum & abdomial wall hematoma due to rupture of a distended paraumbilical vein. Portal hypertension often leads to collateralization of blood flow via variceal vessels, which shunt blood from the portal to the systemic circulation. Rupture of an intra-abdominal varix is an unusual complication of portal hypertension. The differential diagnosis and management of hemoperitoneum in this cirrhotic patient are discribed, with a review of 21 previously reported cases of intra-abdominal variceal bleeding.