Vol. 7, Issue 2, Part A (2025)

Bleeding into the posterior aspect of peritoneal space is termed as Retroperitoneal hematoma. Most of the cases of Retroperitoneal hematoma could not be identified in early stages because of lack of clear signs and symptoms. Clinical features usually appear only after a significant amount of bleeding has occurred. Based on the etiology of bleed it is broadly classified as Traumatic & Non traumatic. Based on the anatomical location of bleed it is classified into 3 Zones. Anticoagulation is a part of management in cases of Cardiac valve replacement. Anticoagulation if not properly monitored in regular intervals can lead to spontaneous bleeding manifestations. In this article we are presenting a case of Spontaneous retroperitoneal hematoma with Left lower zone Lung collapse with consolidation and Sepsis in a case of Double valve (Mitral& Aortic) replacement on oral warfarin with recent history of Right Hip Hemiarthroplasty. In this article we are emphasizing on Balancing Anticoagulation vs Preventing expansion of Hematoma and Containment of Sepsis in such difficult scenarios.