Sudden, unexpected death due to massive, nontraumatic intra-abdominal hemorrhage in association with cirrhosis of the liver

Hemoperitoneum is usually due to rupture, laceration, or perforation of a blood vessel or organ. The author describes three deaths due to massive intra-abdominal hemorrhage, all in alcoholics with cirrhosis of the liver, in which no source for the bleeding was found. One of the three individuals, who was briefly hospitalized, showed evidence of a disseminated intravascular coagulopathy (DIC). In the author's opinion, this is the most likely cause of the intra-abdominal hemorrhage in the two other cases and is related to the cirrhosis of the liver.