A hematoma, bruise, or simply bruise is a leakage of blood from an injured blood vessel. This blood then accumulates in body tissue or in a pre-existing body cavity. Colloquially, a bruise is also called a blue spot and, in the eye, a violet.
What is a bruise?
In medical terminology, a bruise is called a hematoma. It is often visible as a blue-green spot (bruise) on the skin. Bruising describes the leakage of blood from a person’s circulatory system. However, the leaked blood gets into the body tissues or into a pre-existing cavity of the body. In medical terminology, a bruise is called a hematoma. It is often visible as a blue-green spot (bruise) on the skin – if it occurs in the area of the joints, they can only be moved to a limited extent or not at all. The area can be very sensitive or cause pain, but there are also painless bruises. As a rule, bruises are not dangerous. However, if such hematomas occur in the brain, i.e. a cerebral hemorrhage or other internal hematomas, urgent medical attention is needed. In those with hemophilia, hematomas can occur even from simple injuries. Similarly, osteoarthritis may be favored by bruising within joints such as the ankle, knee and hip.
Causes
Bruising usually results from external force, such as bumps, blows, and falls. However, hematomas can also occur after surgery. Often, bruises swell up a lot and can be very painful. The bruise is usually preceded by an injury. Blows or bumps trigger the characteristic bruises on the skin. They also often occur during falls in the places where the person hit during the fall. Such a bruise is usually harmless and does not require further treatment. Bruises, such as those that can occur during sports, can cause a bruise to extend to a joint. In this case, the joint becomes immobile and painful until the clotted blood has been completely broken down by the body. Bruises are also normal after surgical procedures. They occur mainly around the incision site and are simply a sign that the body has noticed the procedure as an injury. A bruise that has developed with no apparent cause should be placed under close observation. If it becomes apparent over the next few days or weeks that there is an increased incidence of such bruising, it is reasonable to suspect that there is a serious underlying condition. Spontaneous bruising is one of the signs of various types of cancer. Anyone on medication should read the package insert, as thinning blood can lead to hematomas and is a known side effect of many medications. In any case, however, it is worth talking to the doctor treating you.
Diseases with this symptom
- Hemophilia
- Muscle fiber tear
- Willebrand-Jürgens syndrome
- Leukemia
- Sprain
- Blood clotting disorder
- Cruciate ligament rupture
- Strained ligament
- Torn ligament
Diagnosis and course
Hematoma diagnosis follows from the symptoms or from an accident history. In the case of initially ambiguous complaints (for example, blood accumulation in body cavities), the location and size of a hematoma can be determined by ultrasound. Particularly extensive or rapidly expanding bruises indicate that large blood vessels may have been injured. Hematomas that develop for no apparent reason may be due to blood clotting disorders. A physician should be consulted for larger hematomas to rule out broken bones, joint injuries or infections as causes. While a freshly formed hematoma is painful, pain and swelling decrease as it progresses. At times, bruising presses on veins, leaving muscles and nerve tissue with inadequate blood supply.
Complications
Bruising is usually only a cosmetic problem – unless the blood clots in a joint. Once it has completely clotted, the joint may have limited or no movement, causing pain. Before it can be safely moved again, the clotted blood must be broken down. Since such bruises are usually a joint injury anyway, the joint is immobilized.Bleeding can be reduced by following the PECH rule in the event of an injury and immediately cooling the joint and elevating it. This is also a good way to avoid unnecessarily large bruises on any other part of the body. Another complication with bruising can be that it is thought to be the only injury – meanwhile other, deeper-seated injuries are overlooked. Broken bones, bone fractures and injuries to internal organs can lead to externally visible bruises. Therefore, especially larger or very painful bruises must be thoroughly examined, simple palpation is not enough – moreover, the patient should contact the doctor if he or she has noticed an unusually large, painful bruise on his or her own and has not yet been able to have it examined. A very large bruise can lead to inflammation during healing, in which case the doctor would need to surgically remove the clotted blood and clean the wound.
When should you go to the doctor?
A bruise or hematoma is bleeding that does not come out. Usually the hematoma occurs when we bump ourselves without falling down. The bruise changes color over time and becomes smaller and smaller. Even though it can cause strong pain, the bruise is rarely a reason to see the doctor. However, severe bruising after traffic accidents or threatening falls should always be treated medically. These include bicycle accidents, scooter accidents, and car accidents involving children and adults. There is a risk of internal injuries, which can only be ruled out by X-ray examinations. If elderly people fall in the home, seeing a doctor is also important. The risk of broken bones and other injuries increases with age. If a person suffers a sports injury, he or she should also see a doctor as a precaution. Brain hemorrhages are life-threatening and often require surgery. If circulatory problems, restricted movement or even fever occur after a fall, the doctor must always be consulted. If bruises form for no apparent reason, caution is advised. Sometimes a blood clotting disorder is the reason. More common than hemophilia is the genetic Willebrand-Jürgens syndrome, in which blood clotting is delayed by a missing protein. Some liver diseases also present with increased bruising. Certain medications promote the occurrence of hematomas, for example painkillers containing acetylsalicylic acid and cortisone.
Treatment and therapy
A bruise caused by injury must be cooled immediately after the injury occurs. The cold causes the blood vessels to constrict and the bruise cannot spread as much. The same applies to injuries to the joints during sports. The faster you cool, the less damage there is. If pain occurs after the bruise, various pain ointments can be used to relieve it. Normally, a bruise heals within two to three weeks. If a bruise is treated with cooling, the pain and spread will be contained. This effect is due to a contraction of the blood vessels in the cold, as less blood can escape. During healing, a bruise changes color more often as the blood residue is broken down by the body. The following color phases can be mentioned:
- Red: small vessels burst open, blood enters the tissue.
- Dark red to blue: blood clots
- Brown to black: degradation of hemoglobin to bile pigment.
- Dark green: degradation of hemoglobin to bile pigment.
- Yellow to brown: degradation of hemoglobin to bile pigment.
Bruising becomes dangerous if it occurs in the brain area or if the affected person suffers from hemophilia. In this case, the patient must be immediately hospitalized for treatment – otherwise he may bleed to death or suffer serious sequelae.
Outlook and prognosis
Bruises usually heal without medical treatment. After just three days, the bruise should lose color and thus recede. However, in some cases, there could be complications that require urgent medical attention. If severe pain appears together with a bruise, it is urgent to be examined by a specialist. In such a case, internal bleeding may have occurred.Only with explicit treatment can serious consequential damage be avoided. Particularly large hematomas should also be examined by a physician. It could be that a larger blood vessel has been injured. If no treatment is given in such a case, shock and high blood loss may result. Infections can also result from a bruise, which should definitely be treated by a doctor. Otherwise, it can lead to bad inflammations, which can only be inhibited by taking antibiotics. Thus, the general rule is that anyone who discovers a bruise need not worry at all. Normally, a bruise heals itself within a few days. In rare cases, complications can occur, which in any case require medical treatment.
Prevention
You can prevent a bruise by following simple safety rules in your professional and personal life. This is especially true when playing sports or in other situations where injury and a bruise can easily occur. If an injury does occur, you can at least try to prevent a large bruise by cooling it. If you intervene quickly enough, you may even be able to prevent a visible bruise from developing. Special care should be taken with hemophiliacs or patients who have to take blood-thinning medication. If possible, they should avoid situations in which bruising may occur.
Home remedies and herbs for bruising
- A bath with arnica helps to treat injuries, bruises, contusions, stimulates circulation and gives a fresh appearance. For a full bath you need three tablespoons of arnica essence.
What you can do yourself
Bruising can be avoided by removing troublesome accident sites. Likewise, it is important to refrain from extensive sunbathing, as this thins the skin. If bruising still occurs, a cooling ice pad is effective and quickly provides relief. Furthermore, there are a variety of home remedies and remedies that counteract bruising and accelerate healing. An arnica-rosop-sage tincture is particularly suitable. For this, 20 grams of arnica must be mixed together with a little hyssop and sage with 250 milliliters of high-proof alcohol. The mixture should be stored for about twelve days. After that, the arnica leaves should be removed from the solution and stored in a bottle. Arnica is extremely effective as an overlay for bruises and at the same time reduces the pain of existing swellings. In addition, another herbal mixture is worth mentioning. It consists of arnica, legwort, St. John’s wort and mullein, as well as calendula. Here, ten grams of each herb are needed. The whole must be boiled in hot water for ten minutes. After that, the mass should cool. Only then can it be applied to the bruise as a kind of compress. However, users should note that this mass should not be spread on open wounds in any case.