Whilst haemorrhage from the stoma is a classical complication of ileal canal, portal hypertension is rarely responsible since only six cases have been reported in the literature before that described here. The responsibility of portal hypertension having been confirmed by umbilico-portography, and a mesenterico-caval shunt was performed. This did not prevent a further bleed 15 months later which led to the discovery of obstruction of the shunt. Despite this there were no further problems up to the time of the patient's death 22 months later as a result of encephalopathy. On the basis of the present case and those already published, the authors discuss the mechanisms and therapeutic possibilities of this rare complication.