We discuss the case of a 55-year-old woman with a history of gastric ulcer, mechanical tricuspid and mitral valve replacement and a pacemaker for post-operative total heart block. The patient underwent elective pacemaker replacement. She developed a large infra-umbilical rectal sheath haematoma during bridging therapy with low-molecular-weight heparins (LMWH), for which she was treated with angiographic embolisation of the epigastric artery.
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