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A 66-year-old male, admitted for abdominal pain, had undergone a cold snare polypectomy (CSP) 6 hours beforehand for a colon polyp (figure 1A–D). He had been prescribed 15 mg of rivaroxaban for non-valvular atrial fibrillation, which he had also taken that day. The patient presented with vital signs within the normal range, and anaemia was not observed (haemoglobin 148 g/L). Contrast-enhanced abdominal CT revealed a giant haematoma in the transverse colon wall with arterial bleeding inside the haematoma (figure 2). An endovascular opinion was sought but due to anticipated difficulty in selectively embolising the target vessel the patient underwent surgery. Emergency laparotomy revealed swelling of the transverse colon (figure 3A), and a right-sided hemicolectomy was performed (figure 3B, C). The patient was discharged 16 days after the operation without any adverse events. Two factors likely increased the risk of haematoma in this case. First, the snare sheath was pulled with excessive force after the initial snare closure failed to cut through the tissue. Second, anticoagulant use could have contributed to the observed outcome. However, as demonstrated in our case, if the snare fails to cut through tissue, particularly in patients on anticoagulants, it should be released and closed again carefully, capturing less tissue.