The color of the hematoma can be different - from bright red to purple, most often it is heterogeneous - its edges are darker, bluish in color, and the inside of the hematoma is red. Below in the article you will find the causes of the disease; the doctors who treat him; necessary medical procedures for treatment; as well as general information about the disease, its localization, features of diagnosis of diseases and their treatment. However, we advise you to consult a doctor, because self-medication in 90% of cases is fraught with the disease progressing to the chronic stage with extremely unpleasant complications
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Causes
Hemorrhage usually occurs after injury. This could be a bruise of the skin, internal organs, a concussion or bruise of the brain, an injection with thin (sharp) objects. Sometimes blood leaves the vessels and pours into the skin and internal organs as a result of infections, autoimmune diseases, and poisoning. The occurrence of hemorrhages and bruises is promoted by increased fragility of blood vessels, fasting, lack of vitamins in food, high blood pressure, and congenital bleeding disorders.
At CELT you can get a consultation with a traumatologist-orthopedic specialist.
- Initial consultation – 3,000
- Repeated consultation – 2,000
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Symptoms
A bruise on the skin is always clearly visible. At first it has a purplish-blue color, and then begins to “bloom”, acquiring yellow and green colors. If a sufficiently large amount of blood accumulates under the skin, a protruding lump forms. At first it is very painful to feel, but later the pain goes away.
The outpouring of blood into the internal organs and into the substance of the brain is preceded by trauma. The main symptom is pain. In this case, the hematoma is not visible externally. If bleeding continues, the victim becomes pale, weak, and dizzy. With chronic internal bleeding, anemia comes to the fore. Bleeding in the brain is especially dangerous. Compression of brain structures may occur, sometimes leading to death.
Predisposing factors
The formation of hematomas occurs after injuries, including pinching, blows, squeezing, and bruises. Subarachnoid hemorrhage does not fall into this category, since it does not appear due to trauma, but due to damage to an unchanged vessel. Often small hematomas appear due to eating large quantities of food or drinking alcoholic beverages. This is due to stretching of the gastrointestinal tract and the appearance of cracks.
The development of pathology is influenced by vascular weakness and problems with blood clotting. Often due to a weakened immune system due to infections or age-related changes, the likelihood of pus accumulating in the affected area increases.
Classification of hematomas
In modern medicine, when classifying hematomas, the following are taken into account:
- Relation to the vessel - pulsating and non-pulsating hematomas.
- Localization - in the cranial cavity, internal organs, under the skin or mucous membrane.
- The state of the blood in the affected area is suppurated, clotted, fresh, infected.
- Symptoms – limited, encysted, diffuse.
There are hematomas that do not fall into this classification. For example, intracerebral, intracranial, intraventricular. They are of the epidural or subdural type and cause serious complications.
How do hematomas occur?
Mechanical damage to blood vessels leads to the accumulation of blood that permeates the surrounding tissues. Hematomas can be superficial or deep. According to the location, subcutaneous, submucosal, intramuscular, subfascial formations, and brain hematomas are distinguished. The main factors for their appearance: sudden bruises or pinching of various parts of the body, displacement of bones and ligaments during fractures and dislocations, puncture and penetrating wounds. Most often, hematomas occur as a result of domestic, sports and industrial injuries, after surgical and other invasive medical interventions.
Predisposing factors for the appearance of hematomas:
- decreased blood clotting;
- lack of ascorbic acid and other vitamins in the body;
- increased capillary fragility;
- systemic diseases.
When the vascular walls are damaged, blood flows out of them into the surrounding space, pushing apart and soaking the tissue. Hematomas located close to the surface cause swelling of the integument, numbness in the lesion, sharp or dull pain. Within a few minutes, the swelling spreads, and the skin or mucous membrane over the accumulation of blood becomes blue-purple.
- Pulsating hematomas appear when large vessels are damaged. The blood in them does not form blood clots, flowing from the walls into the cavities and back. When you touch the damaged areas, a fluctuation is felt: an oscillation of the moving liquid.
- Diffuse formations appear when large areas of soft tissue are soaked in blood. In contrast, limited hematomas remain within the cavities.
- Enclosed hematomas resemble tumors. They develop over a long period of time when the cavities are surrounded by a dense membrane of connective tissue.
Soft tissue hematomas
Soft tissue hematomas are divided into 3 types:
- Lungs - appear 24 hours after injury and are accompanied by mild pain. No special treatment is required.
- Medium - appear within 5-6 hours and are accompanied by pain and swelling. The motor function of the limb deteriorates. Consultation with a traumatologist is required.
- Heavy - formed within 2 hours after tissue damage. The function of the limb is impaired, acute pain and diffuse swelling are observed. You should immediately consult a doctor to determine a treatment strategy.
Immediately after the injury, swelling appears, and the skin acquires a purplish-bluish tint. After 5 days, the skin takes on a green tint as hemoglobin breaks down. Gradually, the hematoma resolves and “flows” down.
If there are no complications, the hematoma will resolve on its own. In the worst case, a hard area appears that causes discomfort and impairs motor function. When an intramuscular lump forms, external symptoms are rarely observed, but the limb swells significantly and an area forms inside, the touch of which causes severe pain.
Note! For chronic intramuscular hematomas, an MRI is prescribed to determine the location and extent of tissue damage.
When large lumps form, surgical intervention is required. Treatment is carried out by a traumatologist. The opening of infected seals is performed by a surgeon after a comprehensive diagnosis. The operation is performed on an outpatient basis, but for large hematomas hospitalization is required. An autopsy is performed, during which blood clots are removed and washing is carried out. Drainage and suturing are required. Sutures are not applied only for infected hematomas. Antibiotics are often prescribed in combination to eliminate the infection.
Symptoms of hematomas
Subcutaneous hematomas are initially clearly limited in area and have a rich dark color. When the lesion is touched, it causes severe or moderate pain. They require virtually no treatment. Within a few days or weeks, small and large bruises will resolve on their own. Red blood cells in blood clots disintegrate under the action of enzymes:
- bright purple formations become lighter;
- then acquire a greenish or yellowish-blue tint;
- gradually fade and disappear.
Pain and swelling also decrease and disappear.
With deep hematomas, the skin may not change color, since blood clots are not visible through it. The main signs of such formations are: severe pain, limited mobility of the injured part of the body, a feeling of fullness, numbness. The blood in them coagulates within several hours, forming dense accumulations. Less likely to lyse - remains liquid, as platelets are destroyed and lose their ability to clot. Pain during body movements and palpation of injured areas persists for a long time or gradually increases.
In complicated cases, the hematoma cavities become infected and suppuration develops. The formation of an abscess, phlegmon or sepsis becomes possible. Sometimes the clots become scarred and form foci of fibrosis. Feverish symptoms may also appear: fever, chills, muscle aches.
Often deep intramuscular injuries require opening and drainage. The blood in such hematomas can be gel-like, liquid or almost solid, separated from the surrounding tissue.
With brain hematomas, the symptoms are nonspecific:
- dizziness;
- headache;
- noise in ears;
- decreased sensitivity in various parts of the body.
In some cases, decreased vision, photophobia, impaired coordination of movements, increased anxiety, sleep problems and other neurological manifestations are possible. The clinical picture depends on the location of the damage.
Intracranial hematomas
Intracranial hematomas are divided into the following types:
- Epidural.
- Subdural.
- Intracerebral.
- Intraventricular.
Epidurals appear in 1-3% of cases and are due to injury to the middle meningeal artery. Pathology is often observed with skull fractures or depressed fractures. A hematoma develops in 2-3 hours or within 24 hours. Lack of treatment leads to coma. The first symptoms are confusion and weakness. Children rarely lose consciousness after a severe blow. Significant swelling of the brain does not lead to the detection of a light gap (which is rare in adults).
Subdurals appear in 1-7% of cases and pose a threat to human life, since death occurs in 60% of cases. There is an acute, subacute and chronic form of the pathology. Bleeding occurs due to a rupture of a vein or artery in the damaged area. People report nausea and severe headaches. Symptoms characteristic of compression of the brain stem are often observed. Lack of treatment and worsening symptoms lead to coma.
Intracerebral are observed extremely rarely with severe traumatic brain injuries. The light gap is not visible, the development of pathology occurs quickly. Hemiplegia or hemiparesis often occurs, as well as extrapyramidal symptoms.
Intraventricular diseases are rarely diagnosed due to the serious condition of patients. There are acute disturbances of consciousness, an increase in body temperature, a decrease in heart rate, and an increase in blood pressure. To establish a diagnosis, a survey of close people is carried out, since the patient is unconscious. To establish the location of the hematoma, MRI is used. In the most severe cases, lombal puncture is used.
Treatment of hematoma on the leg
Typically, a hematoma on the leg after a bruise is treated by two methods: conservative and surgical. The first category includes: cold and warm compresses, pressure bandages, taking analgesics, applying ointment, physiotherapeutic manipulations.
The second group involves performing a puncture - surgical removal of accumulated blood from the site of a bruise with the application of a suture and an aseptic bandage.
Treatment of a serious hematoma on the leg must be carried out under the guidance of a doctor; this will speed up the healing process and prevent unpleasant consequences.
Diagnostics
A hematoma is diagnosed by visual examination. If the hemorrhage is located deep under the skin, in internal organs, or in a joint, it is often very difficult to assess its size and possible consequences.
Patients are prescribed an examination, which may include:
- Ultrasound of internal organs, joints;
- computed tomography and magnetic resonance imaging;
- puncture (puncture with a needle): for example, a puncture of the knee joint is often done if there is a suspicion that blood has accumulated in it after an injury.
Complications and prognosis
With timely diagnosis and high-quality treatment, retrochorial hematoma in most cases does not pose a further threat to the course of pregnancy, which ends safely through the natural birth canal, especially if the hematoma occurs in the early stages of pregnancy. But unfortunately, partial chorion detachment can also cause the formation of early placental insufficiency, premature aging of the placenta and fetal malnutrition. The risk increases with bleeding occurring at 7–12 weeks of pregnancy; in this situation, pregnancy may cease to develop in 5–10% of cases. Retroplacental hematoma that occurs in later stages of pregnancy, especially located below the umbilical cord insertion site, is accompanied by the risk of spontaneous miscarriages, premature abruption of a normally located placenta, premature birth, retarded fetal growth and development, and the development of feto-placental insufficiency.
Another important prognostic sign is the size of the hematoma - the prognosis is considered unfavorable if the volume of the hematoma is more than 60 cm³ or if the area of the hematoma is 40% or more of the size of the fetal egg.
Conclusions:
- Retrochorial hematoma may be an asymptomatic, incidental finding on ultrasound.
- Spotting bloody discharge from the genital tract in the presence of a retrochorial hematoma is a favorable symptom of its emptying.
- Even in the absence of bloody discharge from the genital tract, in the presence of a retrochorial hematoma, complete physical rest and adequate complex therapy are necessary (the most effective is in a hospital setting).
- A hematoma that occurs in the early stages of pregnancy, with timely treatment in most cases goes away without consequences.
- The prognosis for the further course of pregnancy after the formation of a retrochorial hematoma depends on the period of pregnancy at which it appeared, its location, and its size.
And most importantly, in the presence of such a complication, do not panic, but strictly follow all the recommendations of the attending physician. Then you will have every chance to safely and happily carry and give birth to a healthy baby on your own!
Treatment
Minor bruises can be treated conservatively: physiotherapeutic procedures and medications are prescribed.
In case of large accumulations of blood, the hematoma is treated surgically: it is opened, the blood or pus is evacuated, washed with antiseptics and drainage is installed. Antibiotics are prescribed if necessary.
When hemorrhaging into internal organs, it is often necessary to perform surgical intervention, during which it is necessary not only to remove the spilled blood, but also to stop the bleeding.
The multidisciplinary CELT clinic employs experienced traumatologists and surgeons who perform operations on hematomas of various locations. Modern techniques used in our clinic help provide effective treatment and minimize the risk of complications.
Drainage of hematoma and other methods of its treatment
The human body is riddled with blood vessels.
During domestic, industrial or sports injuries, the integrity of the wall of a particular vessel is compromised. This can lead to bleeding or hematoma formation. Hematoma is an accumulation of liquid or coagulated blood in the thickness of soft tissue. This is often a harmless phenomenon, but in some cases doctors are often faced with the need to remove a large hematoma, which can interfere with the functioning of tissues and neighboring organs. Hematomas can form:
- for all types of injuries – closed and open;
- in any part of the human body;
- for injuries of any degree - from minor (in this case, the role is played not by physical effort, but by the fragility of the vascular wall) to severe.
Hematomas can occur not only when physical force is applied to the tissues, but also several hours and days after that. An example is an internal hematoma after surgery - when sutures placed on blood vessels damaged during surgery fail. The possibility of such tissue hemorrhages must be constantly remembered. The timeliness of diagnosis, and therefore the success of hematoma treatment, depends on this.
Orthopedics and traumatology services at CELT
The administration of CELT JSC regularly updates the price list posted on the clinic’s website. However, in order to avoid possible misunderstandings, we ask you to clarify the cost of services by phone: +7
| Service name | Price in rubles |
| Appointment with a surgical doctor (primary, for complex programs) | 3 000 |
| X-ray of the chest organs (survey) | 2 500 |
| Ultrasound of soft tissues, lymph nodes (one anatomical zone) | 2 300 |
All services
Make an appointment through the application or by calling +7 +7 We work every day:
- Monday—Friday: 8.00—20.00
- Saturday: 8.00–18.00
- Sunday is a day off
The nearest metro and MCC stations to the clinic:
- Highway of Enthusiasts or Perovo
- Partisan
- Enthusiast Highway
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