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Large spontaneous perirenal haematoma following percutaneous transluminal coronary angioplasty. Perirenal haematoma is a rare and life-threatening condition in view of severe and ongoing blood loss. Most common causes are renal cancer, angiomyolipoma and vasculitis. Spontaneous causes of this rare entity may occur with use of anticoagulants and antiplatelets. We report a 61-year-old male patient diagnosed with large perirenal haematoma following percutaneous transluminal coronary angioplasty for myocardial infarction under heparin cover that was managed conservatively.