Definition
A bruise (haematoma) usually results from blunt trauma, such as bumping into an object. This causes small blood vessels to burst, so that blood accumulates under the skin and becomes noticeable by a discoloration. There is no injury to the skin. In principle, a bruise is nothing more than a bruise. However, it is usually called a bruise if it is a larger or darker bruise.
Causes
Causes of bruising are blunt traumas, such as bumping into an object, a fall or similar. Especially in small children, who can already move more than babies, bruises are actually unavoidable. However, if babies have a conspicuous amount of bruising that cannot be attributed to any apparent trauma, this should be examined by a doctor, as it may be a congenital blood-clotting disorder.
Diagnosis
For the diagnosis of a haematoma, no additional diagnostics is usually necessary – it is a gaze diagnosis, which is particularly clear when the parents report an associated matching trauma. If it is a bruise on the head/behind the ear, an imaging with CT or MRI of the skull is often performed to rule out a skull fracture. In some cases, the treating physician also performs an ultrasound examination to rule out the accumulation of blood in body cavities or to be able to assess the extent of the bleeding.
Associated symptoms
A bruise is typically accompanied by pressure pain, sometimes accompanied by swelling. The pain is caused by the blood accumulation compressing deeper tissue layers. The typical discoloration of a bruise does not usually occur immediately after the injury, but is often not observed in the baby until the next day.
If a fever accompanies the bruise, it should be checked by a doctor. In addition, bruises can rarely develop into an increasing swelling that appears to be filled with pus. In this case, a doctor should also be consulted.
Duration
The duration of a bruise varies from person to person. It usually takes a few days to a few weeks before it disappears completely. Typically, a bruise goes through different stages of colour.
At first it is deep blue, then it turns brownish and finally yellow-green. These different colourings are caused by the process of blood breakdown in the tissue. On average, one can say that a bruise disappears after 14 days. However, some bruises can be more persistent.
Treatment
A bruise does not necessarily require treatment, as it disappears by itself even without therapy. However, especially with babies, additional measures are often taken to treat the bruise as little as possible, understandably so. Often a subsequent care and distraction of the baby after the triggering situation is sufficient so that the baby recovers quickly from the shock.
The only exception to this is a cerebral haemorrhage as part of a craniocerebral trauma following a blow or fall on the head, which must be treated surgically in any case. To prevent subsequent swelling, cooling immediately after the trauma can provide relief. It is therefore best to store cold compresses in the freezer just in case.
However, they should never be applied directly to the skin, but should be wrapped with a kitchen towel, for example, to prevent hypothermia/freezing of the affected area. Cold causes the blood vessels to contract, resulting in reduced swelling of the tissue. Ointments with arnica and heparin have also become established as treatment ingredients.
An example of this is the popular Traumeel ointment with a total of 14 different ingredients, which can be used to alleviate blunt injuries. Some leech ointments are also used, which also has a decongestant and anti-inflammatory effect. For babies older than three months, paracetamol pain suppositories can also be used for visibly severe complaints. Unnecessary movements of the child should be avoided if possible in the case of a larger bruise. This is because movement promotes blood circulation, so that the bruise can become larger and the swelling can increase.
