A preventable cause of acute abdomen.

Haemoperitoneum is an extremely rare presentation of hepatocellular carcinoma in the industrialised world. We present the first reported case in the UK. In contrast, up to 10% of hepatocellular carcinomas in Africa present in this way, the median time between presentation and death being just six weeks. Hepatitis B infection at birth and during childhood is the major cause of hepatocellular carcinoma in the developing world. The World Health Organisation, UNICEF and the World Bank have all advocated routine hepatitis B vaccination of children. This can reduce the burden of disease in these communities, among people in their productive years of life.