A mass brawl breaks out amongst the Gloucester and Sale players. Photo / Getty
The ref eventually showed Twelvetrees a yellow card and he may yet face further sanction for his brain explosion.
Sale held on to win the game, their first under caretaker boss Paul Deacon.
After the game, Deacon tried to play down the incident, saying: "Emotions boil over, and I think a lot of people make it a bigger issue than it actually is.
"I don't think there was anything untoward, really. It just didn't look great."
Twelvetrees' indiscretion is the latest in a long line of sports stars taking out their frustrations on those working the sideline.
In 2013, Chelsea star Eden Hazard kicked a 17-year-old ballboy at Swansea after the young lad was slow in releasing the ball.
Hazard later apologised to the boy in the sheds.
"I think I kicked the ball and not the boy. I apologise. The ballboy came in the changing room and we had a quick chat. I apologised and the boy apologised as well, and it is over. Sorry."
Last year, tennis ace Novak Djokovic was bounced from the US Open after hitting a line judge with the ball during his fourth-round match with Pablo Carreno Busta.
Novak Djokovic pings a line judge in the face and gets DISQUALIFIED from the US Open 😮 That is not a way you want to get eliminated in a major pic.twitter.com/2EY3oRdBP6
After losing the first set, Djokovic hit the ball in anger, hitting the line judge in the throat.
Djokovic tried to plead with the umpire, arguing that "she doesn't have to go the hospital or anything" but was sent packing for "intentionally hitting a ball dangerously or recklessly within the court".