A 60 years old women presented by progressive abdominal distension and abdominal pain. When presented ultrasound guided abdominocentesis confirmed intraperitoneal hemorrhage further assessment by abdominal-pelvic CT scans showed leaking sub capsular hepatic focal lesion consistent with hepatocellular carcinoma. The patient was treated conservatively and 2 months later she experienced recurrent abdominal pain and sub acute intestinal obstruction. Ultrasonographic examination showed intrabdominal loculations(figure 1). The differential diagnosis of this condition includes intraperitoneal hemorrhage due to other causes, abdominal TB and recurrent spontaneous bacterial peritonitis in ascetic patients. .