A 67-year-old man presented to the emergency department with abdominal pain and groin bruising. He had no history of any disease or drug use. In his breaf story he had a heavy cough five days ago and bruises appeared on the abdomen skin and groin in the last two days. Ecchymosis extends in the midline from umblicus to the penis and scrotum in physical examination (Figure 1). Laboratory evaluation revealed normal hemoglobin level, platelet count, prothrombin time, and activated partial thromboplastin time. [West J Emerg Med. 2014;15(7):–0.]