In patients with liver cirrhosis and portal hypertension collateral circulation can develop to direct blood from portal to systemic veins allowing decompression of the portal system. A potential complication of portal hypertension is rupture of collateral vessels with subsequent fatal hemorrhage, occurring most commonly in the esophagus. The paraumbilical vein is a recognized collateral pathway in patients with portal hypertension however cases of rupture have been rarely documented. The authors report a case of hemoperitoneum caused by rupture of a paraumbilical vein into a paraumbilical hernia in a man with liver cirrhosis and portal hypertension. Post mortem CT imaging was valuable in localizing the source of hemorrhage in this case.