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Gallbladder perforation with hemorrhage may be the source of massive hemoperitoneum under rare and extreme cir-cumstances. In cirrhotic patients the bleeding may be associated with the tearing of gallbladder varices and represents afatal complication, as reported in all the cases available in literature. The incidence of gallbladder varices in the settingof portal hypertension ranges 12-30%, although literature data are limited. We describe the case of an end-stage cirrhotic patient without portal thrombosis awaiting for orthotopic liver transplan-tation, who developed a fatal hemoperitoneum caused by massive bleeding from ruptured varices of both gallbladder walland cholecystic fossa. The review of the literature was also performed.
