Synonyms
Bruise, bruise
General
A bruise (haematoma) is the often visible accumulation of blood in the subcutaneous tissue (subcutis) or deeper lying skin tissue, more rarely also in a previously existing body cavity. In general, a hematoma is a sign of illness (symptom) that indicates an injury or the use of force. In rare cases, however, it can also be due to a more serious underlying disease.
Depending on its extent, a hematoma either requires no therapy, in-house care or hospital treatment. A clear distinction from a hematoma is made by the death spots, which, although they look partly similar and are also caused by blood in the tissue, in contrast to a hematoma they occur exclusively in cadavers. In general, a hematoma is a frequently occurring symptom, as even slight injuries in everyday life can trigger one in otherwise healthy people. However, they are particularly common in young children learning to walk and older people who are insecure about walking.
Causes
The most common form of hematoma is a direct result of a vascular injury caused by force. Whether this is done by a third party with malicious intent, through an accident or as part of a medical intervention (operation) is secondary. The bruise caused by a sports injury is also called a horse kiss.
In the presence of a disease that affects blood coagulation (hemostasis), such as the hereditary (hereditary) disease of hemophilia or blood cancer (leukemia), a bruise (hematoma) can occur after a minor trauma or even without an accident (trauma). Depending on its localization, size and shape, a hematoma may allow conclusions to be drawn about the type of injury, such as a specific fracture of a bone, or in forensic medicine about the type of weapon used. Another factor that should not be neglected is the use of anticoagulant drugs (such as Apixaban or Marcumar).
Symptoms
The main symptom of a hematoma is the discoloration caused by the blood that has leaked into the tissue, more precisely by the blood pigment (hemoglobin) that is found in the red blood cells (erythrocytes). Over time, both the color and the color intensity of the hematoma change from intense, primarily red-blue to greenish to pale yellow due to the body’s own degradation steps. Depending on the localization, hematoma size and individual metabolic rate, this process of discoloration takes a few days to several weeks.
The coloration of an existing hematoma therefore allows only very limited conclusions about the time of its development. In addition to the change in color, the leaked blood is also expected to cause swelling of the region. Depending on the extent of the hematoma, a feeling of tension as well as pain (especially when touching or pressing the affected area) may also occur.
Complications of a hematoma are to be expected above all when the swelling caused by the hematoma exerts pressure on surrounding structures, which in the case of spatial constriction, for example, can lead to a compression of the surrounding structures, such as the brain in the case of a cerebral hemorrhage or the vessels and nerves in the case of a so-called compartment syndrome. If a hematoma occurs in joints, especially in the knee joint, hip joint or ankle joint, the development of premature joint wear (arthrosis) can be promoted. If the hematoma is particularly severe and large in relation to the amount of blood that has leaked out, a potentially life-threatening shock is possible in the short term, even with the correspondingly high blood loss.
In the medium term, the lack of oxygen-carrying red blood cells (erythrocytes) can lead to anemia, which can manifest itself as lassitude, paleness, weakness, tiredness, dizziness and headaches. Undetected larger hematomas are possible, especially in the case of internal bleeding in the hip, abdominal or chest area. A simple bruise (haematoma) in an otherwise healthy person usually does not require therapy.
In case of subjective discomfort, a small hematoma can be treated with simple home remedies such as discreet cooling and elevation of the affected area. A visit to the doctor is particularly advisable if the hematoma is large, if there is no plausible explanation for its development, or if it has not disappeared after several weeks.If necessary, the attending physician will then rule out a more serious injury such as a fracture or the occurrence of complications, or, if the cause of bleeding is unknown, will investigate the cause. In the case of larger hematomas, a locally applied ointment with anticoagulant active ingredients may be used to make the more coagulated blood more accessible to the body for faster breakdown. If complications occur, they must of course be treated separately.
