Symptoms of internal bleeding

Author: Surgeon Denisov M.М.

In modern surgery, special attention is paid to internal bleeding. This is due to the fact that internal bleeding is much more difficult to diagnose than open one. This means that the medical assistance provided may be too late. Internal called bleeding, characterized by the outflow of blood into the natural cavity of the body or artificially created spaces.

Depending on the amount of blood flow, three degrees of bleeding are distinguished: moderate, medium and heavy.

The main causes include: fractures of ribs with rupture of intercostal vessels and damage to lung tissue, malignant neoplasms of internal organs, closed liver, spleen, intestinal damage, complications of diseases of organs such as the esophagus (with varicose veins), stomach and duodenum, liver, female sexual.

Frequency of internal bleeding

Most often, bleeding occurs when the organs of the gastrointestinal tract are affected. Therefore, it is worth getting acquainted with the methods of emergency treatment of gastrointestinal bleeding . A total of about 20 diseases are identified, the most significant and frequently occurring among which are: acute erosive gastritis and gastric cancer, varicose veins of the esophagus, cirrhotic liver damage. In the case of stomach cancer, the risk is a disintegrating tumor. The only sign that allows a patient to suspect a malaise is the darkening of the stool, which occurs due to the clotted blood contained in it. In the event that vomiting occurs, the spewing masses, again due to the coagulated blood, have the color of the coffee grounds.

In some cases, it is necessary to distinguish bleeding from the esophagus, the stomach from bleeding with a damaged lung. In the case of lung pathology, foamy, unchanged blood of scarlet color is allocated.

Diseases of the female reproductive system can also cause internal bleeding. The most common cause is tubal abortion. When the fallopian tube is ruptured, blood accumulates in the abdominal cavity, creating a feeling of tension and some pressure in the pelvis, especially the rectum. By the way, bleeding from the anus is also quite common. Later, irritation of the peritoneum occurs with blood, which leads to the development of a shock state, loss of consciousness, fainting. The pulse in this case becomes frequent and threadlike. On examination, bloating, stool and gas retention are detected. The patient becomes pale, covered with a cold sweat.

Symptoms of hemothorax

In the case of accumulation of blood in the pleural cavity, the so-called hemothorax develops. The pleural cavity is a small space in space separating the lungs from the chest. To the causes leading to the development of hemothorax, include the following: falls from height, trauma with damage to the ribs and intercostal vessels, stab wounds, lung cancer, lung abscesses (that is, the formation of ulcers in the lung tissue).

With the accumulation of blood in the pleural cavity there is difficulty in breathing during inspiration and coughing, severe pain in the chest, a general state of dizziness, weakness, fainting, pale skin, rapid pulse and sweating, sweating. When percussion of the patient's thorax, a shortening of the percussion sound over the affected half is revealed, a weakening or complete absence of breathing. On the roentgenogram, it is possible to determine the signs of displacement of the mediastinum towards the healthy lung.

Hemarthrosis

Frequent damage to the joints is the development of hemarthrosis, which means the accumulation of blood in the joint cavity. There is a similar condition as a result of trauma, less often with hemophilia, scurvy. An anemic symptom is expressed slightly, in contrast to the local symptomatology. The clinic distinguishes three degrees. At a hemarthrosis of 1 degree there is a weak pain, contours of a joint are slightly smoothened, the volume of movements is not changed. In general, the amount of blood in the joint is up to 15 ml. 2 degree is characterized by a pronounced pain syndrome, which is strengthened during exercise, joint smoothness is noted. There is an increase in the circumference of the affected joint by 1.5 to 3 cm compared with the healthy one. In the case of hemarthrosis of the knee joint ballotation of the patella is observed. The blood content in the cavity is up to 100 ml. At 3 degrees the pain syndrome is expressed sharply, the outline of the joint is completely changed. In the circumference of the joint increases to 5 cm, sharply limited mobility. The blood volume is more than 100 ml.

General symptoms

Thus, there are signs of bleeding that occur in any case, regardless of the source of the bleeding. The early signs include: pallor of the skin and visible mucous membranes, cold sweat, general weakness, dizziness, darkening in the eyes, lung damage - cough with blood veins, involving the digestive system - bloody vomiting or bloody diarrhea, symptoms of irritation of the peritoneum , which occurs when ruptured internal organs (spleen, liver, kidney).

In other words, bleeding leads to the development of anemia. In addition to this symptomatology, anemia is manifested by increased heart rate and hypotension, that is, a decrease in blood pressure. The changed parameters directly depend on the degree of blood loss: with a moderate pulse, no more than 75 beats per minute, systolic pressure is reduced to 100 mm Hg. p. at an average - the pulse rises to 100 beats per minute, the arterial pressure decreases to 90-80 mm Hg. p. when severe - the pulse rises to 120-140 beats per minute, systolic blood pressure drops below 80 mm Hg. Art.

Diagnostics

An important point in confirming the diagnosis is conducting laboratory blood tests. The analysis reveals a decrease in the number of erythrocytes, the amount of hemoglobin and the drop in hematocrit.

When identifying such symptoms and diagnostic data, you must immediately identify the cause of the underlying disease and begin treatment. It should be remembered that the earlier the cause of internal bleeding is revealed, the more effective and quick the process of recovery will be.