{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T22:04:21Z","timestamp":1792015461435,"version":"4.4.0"},"reference-count":30,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,7,16]]},"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:p>Retroperitoneal haemorrhage (RH) is not uncommon in patients with provoking events like trauma. However, spontaneous RH (SRH) is a rare and life-threatening complication described as the development of bleeding into the retroperitoneal cavity, appearing spontaneously and without a preceding history of trauma or other predisposing illness. We are reporting a case of an elderly patient with recurrent deep vein thrombosis who had developed SRH secondary to concurrent use of multiple anticoagulation agents, resulting from poor healthcare follow-up and lack of sufficient medication reconciliation. This article highlights the significance of recognising risk factors for SRH, as well as management strategies through literature review.<\/jats:p>","DOI":"10.1136\/bcr-2021-242934","type":"journal-article","created":{"date-parts":[[2021,8,17]],"date-time":"2021-08-17T13:02:22Z","timestamp":1629205342000},"page":"e242934","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Spontaneous retroperitoneal haemorrhage secondary to anticoagulation polypharmacy"],"prefix":"10.1136","volume":"14","author":[{"given":"Mohammed M","family":"Uddin","sequence":"first","affiliation":[{"name":"Internal Medicine, Wayne State University, Warren, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6822-9600","authenticated-orcid":false,"given":"Tanveer","family":"Mir","sequence":"additional","affiliation":[{"name":"Internal Medicine, Detroit Medical Center, Detroit, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Khalil","sequence":"additional","affiliation":[{"name":"Internal Medicine, Detroit Medical Center, Detroit, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeenat","family":"Bhat","sequence":"additional","affiliation":[{"name":"Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita Maria","family":"Noronha","sequence":"additional","affiliation":[{"name":"Internal Medicine, John Dingell VA Medical Center, Detroit, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,8,17]]},"reference":[{"key":"2025082708253250000_14.8.e242934.1","doi-asserted-by":"crossref","first-page":"9375","DOI":"10.1186\/1757-1626-2-9375","article-title":"Retroperitoneal hemorrhage caused by enoxaparin-induced spontaneous lumbar artery bleeding and treated by transcatheter arterial embolization: a case report","volume":"2","author":"Sun","year":"2009","journal-title":"Cases J"},{"key":"2025082708253250000_14.8.e242934.2","doi-asserted-by":"crossref","DOI":"10.1186\/1752-1947-2-162","article-title":"Gigantic retroperitoneal hematoma as a complication of anticoagulation therapy with heparin in therapeutic doses: a case report","volume":"2","author":"Daliakopoulos","year":"2008","journal-title":"J Med Case Rep"},{"key":"2025082708253250000_14.8.e242934.3","doi-asserted-by":"publisher","DOI":"10.1097\/01.SMJ.0000145306.59008.4E"},{"key":"2025082708253250000_14.8.e242934.4","doi-asserted-by":"crossref","first-page":"1046.e1","DOI":"10.1016\/j.ajem.2019.12.049","article-title":"Pain in the hip: spontaneous retroperitoneal hemorrhage in an elderly patient on apixaban","volume":"38","author":"Khan","year":"2020","journal-title":"Am J Emerg Med"},{"key":"2025082708253250000_14.8.e242934.5","doi-asserted-by":"crossref","first-page":"85","DOI":"10.12659\/AJCR.901622","article-title":"Antiplatelet therapy and spontaneous retroperitoneal hematoma: a case report and literature review","volume":"18","author":"Ibrahim","year":"2017","journal-title":"Am J Case Rep"},{"key":"2025082708253250000_14.8.e242934.6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2018\/4397893","article-title":"Spontaneous retroperitoneal bleeding in a patient with primary antiphospholipid syndrome on aspirin","volume":"2018","author":"Ioannou","year":"2018","journal-title":"Case Rep Emerg Med"},{"key":"2025082708253250000_14.8.e242934.7","doi-asserted-by":"publisher","DOI":"10.4103\/2006-8808.78462"},{"key":"2025082708253250000_14.8.e242934.8","first-page":"53","article-title":"Spontaneous retroperitoneal haemorrhage associated with renal disease","volume":"43","author":"Wolff","year":"1998","journal-title":"J R Coll Surg Edinb"},{"key":"2025082708253250000_14.8.e242934.9","first-page":"121","article-title":"Rational approach to evaluation and management of spontaneous perirenal hemorrhage","volume":"170","author":"Morgentaler","year":"1990","journal-title":"Surg Gynecol Obstet"},{"key":"2025082708253250000_14.8.e242934.10","first-page":"1206","article-title":"Nontraumatic hemorrhage in abdomen and retroperitoneum-CT, sonographic and clinical findings. 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