A haematoma in children, also known as a haematoma, is caused by a blunt, violent external impact on the tissue. Small children often contract this injury when playing with others or during sports activities. The sudden increase in pressure on the affected area causes the small blood vessels in the tissue to burst, blood leaks out and deposits under the skin.
In most cases, the surface of the skin is not damaged and remains intact. They often impress as unpleasant and painful. As a rule, bruises do not have a high disease value and heal quickly. Bruises can also occur in babies.
Causes
There are many different causes for the occurrence of bruising in children. Bruises are caused by blunt force trauma. These can occur in children especially during falls, while playing or during sports activities.
Bruising can also occur as a result of surgery or dental treatment. The blood that escapes during these operations flows from the injured body tissue into a preformed body cavity or the surrounding tissue. Young children who suffer craniocerebral trauma in an accident can also develop a bruise.
This can lead to life-threatening complications such as an increase in intracranial pressure or multiple disturbances or failures of the nervous system and requires immediate surgical action. However, haematomas also occur repeatedly without any pre-existing apparent trauma or injury pattern. In these cases, one should always consider a possible coagulation disorder.
Especially in children, attention should be paid in these cases to family-related coagulation disorders and further diagnostics should be initiated. The presence of recent and old bruises without previous trauma, in combination with behavioural disorders or fractures at various stages of healing, can also be indications of physical abuse. They must not be overlooked.
Diagnosis
The diagnosis of a bruise can in most cases be made without any problems on the basis of the history of its origin, appearance and accompanying symptoms. The colouring, the extent of the swelling and the extension give good information about the severity and age of the haematoma. Particularly large haematomas that occur in the head area or haematomas in small babies should be given sufficient attention and a doctor should be consulted for further examination. In order to assess the exact size, extent and, if necessary, other additional injuries, additional imaging procedures such as ultrasound or computer tomography can be used.
Associated symptoms
Bruises are usually accompanied by swelling of the affected tissue. Children usually bother them slightly more than adults because they can be very painful depending on their size and spread. Small, rather superficial bruises usually cause only a slight pressure pain, which usually subsides after 1-2 days.
Slightly larger bruises, which are located deep down, can sometimes be accompanied by severe pain. If they are located close to organs, they can restrict their function and exert a pressure that is perceived as extremely unpleasant. In addition, the resulting pressure on the surrounding tissue can also lead to a narrowing or compression of other blood vessels or nerve tracts.
As a result, there is a risk of so-called necroses, a destruction of the tissue, or also of disturbances in sensitivity and motor function. Bruises in children usually show externally mainly through bleeding under an intact skin surface, which initially appears reddish to bluish and changes to greenish or yellowish after one or two days. When the bruise loses its colour, this is a first sign of the progressive healing process. Particularly large bruises that do not heal as quickly also represent a suitable nutrient medium for germs and bacteria, so that in the event of a newly occurring fever or increasing signs of inflammation (redness, swelling, overheating, pain, limited functionality), accompanied by exhaustion or deterioration of the general condition, one must always consider a spreading infection.
