Improving Diagnostic Image: dose reduction

A  55-year-old male patient had a diagnosis of colon cancer with painful spine metastases. He had a previous diagnosis of atrial fibrillation. He had to stay at the hospital to receive radiotherapy to control back dorsal pain

He was taking at home an oral anticoagulant but it was switch to subcutaneous enoxaparin to prevent also venous thrombosis during his hospital stay. The image shows a subcutaneous bleeding related with enoxaparin.

Cullen sign is tipically periumbilical and the Gray-Turner sign is more lateral, both signs associated with hemorrhagic pancreatitis, retroperitoneal or intraabdominal bleeding.