Intra- and retroperitoneal bleeding may be associated with anticoagulant therapy and presents the gastroenterological surgeon with a diagnostic and therapeutic dilemma. Although these rare types of bleeding may be spontaneous, minimal trauma cannot be ruled out. In the case of retroperitoneal hemorrhage, conservative management may suffice, but in the case of intraperitoneal bleeding, urgent laparotomy may be required. It is not possible to elicit causal factors, and elderly patients on anticoagulant therapy should be carefully monitored on the appearance of any abdominal complaints.

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