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Hemorrhage from recanalized umbilical vein in a patient with cirrhosis

The formation of portosystemic collaterals occurs frequently in portal hypertension; however, the finding of a patent or recanalized umbilical vein has more often been incidental, with only six cases of recanalized umbilical veins or patent paraumbilical veins demonstrated with clinical significance. This is only the second documented case of an umbilical vein with external hemorrhage significant enough to cause hemodynamic instability. It raises important questions with regard to prognostic indices for rebleeding at the umbilicus as well as at other, more common, portosystemic collateral sites.