Bleeding into the retroperitoneal space is a serious complication of anticoagulation. The incidence may be on the rise due to the increasing number of patients prescribed anticoagulants for atrial fibrillation and other disorders. The clinical manifestations vary from leg paresis to abdominal pain or a catastrophic shock. Thus, an adequate index of suspicion is needed to reverse anticoagulation rapidly and initiate other therapeutic measures. We reviewed the cases diagnosed at our institution and reported in the literature to delineate the clinical manifestations and course of this process.

Bleeding into the retroperitoneal space is a serious complication of anticoagulation. The incidence may be on the rise due to the increasing number of patients prescribed anticoagulants for atrial fibrillation and other disorders. The clinical manifestations vary from leg paresis to abdominal pain or a catastrophic shock. Thus, an adequate index of suspicion is needed to reverse anticoagulation rapidly and initiate other therapeutic measures. We reviewed the cases diagnosed at our institution and reported in the literature to delineate the clinical manifestations and course of this process.