A 69-year-old hypertensive gentleman (on amlodipine and metoprolol) presented with atrial fibrillation. Amiodarone and low molecular weight heparin (LMWH-enoxaparin 60 mg twice daily) were commenced. On the third day he developed right (Rt) flank pain, shock (50 mmHg systolic), low oxygen saturation (80%), peri-umbilical ecchymotic patches, and palpable Rt retroperitoneal mass. Laboratory investigations revealed low haemoglobin, 8.3 g%; normal platelets, 210,000/mm 3 ; leucocytosis, 31,000/mm 3 ; azotemia, urea 170 mg%, creatinine, 4.3 mg%; and deranged coagulation, international normalised ratio (INR) 2.7. Computed tomography (CT) of the abdomen was also performed (Figures 1 and 2).