What are the symptoms of internal bleeding? Symptoms and signs of internal bleeding

Health can be shaken by chance. And incomprehensible pains in the abdominal cavity lead to unbearable pain. What caused it is hard to say at first. But bleeding in abdominal cavity It is so dangerous that if you do not resort to its diagnosis and treatment in a timely manner, you can bring a person to death.

The patient may not suspect that he has opened internal bleeding of the abdominal cavity. Although it is almost always preceded by serious injury, under the influence of which blood vessels are disconnected or simply damaged. Specialists distinguish internal traumatic damage to blood vessels. Yes, under the influence hard hit mechanical separation takes place. The deformed vessel begins to bleed. As a result serious problems that need to be fixed as soon as possible.

Another reason why painful separation of blood vessels can occur is chronic diseases: tuberculosis and gastric ulcer. In addition, at oncological diseases internal bleeding of the abdominal cavity may also open.

One of the main problems internal bleeding is that all the blood does not come out. It simply accumulates inside the organs and begins to put pressure on them. But, if a person has chronic diseases, as a result of the progression of which internal bleeding may open, he should be aware of potential problems from his attending physician in advance.

Bleeding into the abdominal cavity: symptoms

Most experts are sure that if the patient is aware of how certain deviations in the body work and what symptoms they are accompanied by, then he can consult a doctor in a timely manner. Although the symptoms of bleeding into the abdominal cavity are not the most pronounced, you can still determine what is happening in it by the state of your body.

To be more precise, bleeding into the abdominal cavity has the following symptoms:

• A sharp drop in blood pressure, accompanied by congestion in the ears and unbearable headache.
• Darkening of the eyes with temporary loss of consciousness. Fainting state.
• chills and great weakness.
• Pallor skin. In some cases, the dermis becomes almost gray.
• The pulse rises sharply.

At first glance, the symptoms seem uncharacteristic and can be attributed to many other conditions of the body. But, it is worth noting that the doctor, despite the complexity of the diagnosis, can almost instantly, knowing about the patient's illnesses or his recent injuries, say what caused this condition.

Signs of internal bleeding in the abdomen

At careful attention to your health, you can independently notice the main signs of internal bleeding in the abdominal cavity. The symptoms start to get worse general state getting worse. But, much depends on which vessel was damaged and how fast the bleeding proceeds. If it's rapid bleeding and damaged large vessels the person can lose consciousness very quickly. With minor bleeding, the symptoms will only increase, and the person will become a little worse. In such cases, the problem can be diagnosed much faster and treated more effectively.

In many ways, the signs of internal bleeding in the abdominal cavity depend on its type. Each of them has specific symptoms. Therefore, it is worth considering in more detail each of them:

• Bleeding flowing into the abdominal space as a result of rupture of the kidneys, aorta, adrenal glands - in addition to the main symptoms, it is accompanied by pain in the lower back. With a slight load on the lower back, the pain begins to intensify.
• Bleeding flowing into the free abdominal cavity due to ruptures of the liver and spleen - severe pain in the upper abdomen, especially on palpation, periodic pain in the right and left shoulder and spine, heaviness in the abdomen.
• Bleeding occurring in the gastrointestinal tract in the presence of chronic diseases occurring in it - the symptoms are very pronounced, vomiting of blood, feces of bright red or black color, very frequent diarrhea while there is no pain in the abdomen.
• Bleeding from the pelvic organs due to tears in the ovaries, uterus and fallopian tubes accompanied severe pain on palpation in the region of the womb, discomfort and pain in the abdomen, pain radiating to the right and left shoulder.

The signs of internal bleeding in the abdominal cavity are many-sided, but they all clearly signal that a person needs to pay special attention to his health and seek immediate help from a specialist.

Bleeding in the abdominal cavity: causes

It is regrettable to realize, but a person's condition can worsen at any moment. Bleeding in the abdominal cavity has very diverse causes, but all of them lead to the fact that you can say goodbye to your health, and maybe life, forever.

Bleeding in the abdominal cavity has the following causes:

• Traumatic: blows, cuts, bruises.
• Chronic: vascular rupture of organs prone to chronic diseases.
• Ectopic pregnancy and diseases of the pelvic organs.
• chronic diseases gastrointestinal tract.
• Oncological diseases of the gastrointestinal tract and pelvic organs.
• Injuries of the lumbar region.
• Excessive physical activity.
• Varicose veins in the esophagus and stomach.
• Malory-Weiss syndrome.

It must always be remembered that internal bleeding in the vast majority of cases (except for injuries) occurs under the influence of the development of a chronic disease. Therefore, the patient can even personally understand that his current changes are caused by the active stage of the course of the disease.

Treatment of bleeding in the abdominal cavity

It is very important to properly treat bleeding in the abdominal cavity. First of all, if the patient complains of at least a slight malaise and he has characteristic symptoms, then it is worth immediately laying it on a bed or on another surface. Being in horizontal position depending on which of the places the pain is localized, it is necessary to apply cooling pads. Before the arrival of the ambulance, they should never be removed. Under no circumstances should you treat bleeding into the abdominal cavity on your own.

After hospitalization, depending on the nature and intensity of the course, doctors independently decide how bleeding into the abdominal cavity will be treated.

If the case is not complicated and the bleeding has completely or practically stopped and was insignificant, it is advisable intravenous administration saline solutions and taking hemostatic drugs.

With active and severe blood loss, immediately surgical intervention in parallel with maintenance therapy.

It must be remembered that the treatment of bleeding into the abdominal cavity should be carried out permanently under the direct supervision of specialists.

Bleeding into the abdominal cavity is a problem that cannot be dealt with on your own. Therefore, a person with chronic diseases must always be on the alert in order to understand in a timely manner what his ailment is and take appropriate measures.

Or, as it is called in medical practice, hemoperitoneum- outflow of blood into the abdominal cavity or into the retroperitoneal space associated with damage to organs and blood vessels lying in this zone. Most often, damage to the vessels located in the omentum, mesentery, folds and ligaments of the peritoneum leads to hemoperitoneum. As for the organs, in most cases, such as the pancreas, liver and spleen are affected.

Intra-abdominal bleeding is fatal dangerous state. But if you know its main symptoms and take action in time, then complications can be avoided.

The reasons

All causes of intra-abdominal bleeding can be divided into two main groups. The first includes the causes of a traumatic nature:

• chest injuries (for example, fractures of the lower ribs can cause damage to internal organs bone fragments);
• blunt abdominal trauma resulting from squeezing, falling, strong blows;
• gunshot or knife penetrating wounds of the abdomen;
• damage after some operations (resection of the stomach or liver, nephrectomy, appendectomy, cholecystectomy) associated with complications, slippage of ligatures used to ligate vessels, or surgeons' mistakes.

The causes of a non-traumatic nature include, mainly, complications of diseases of the internal organs:

• ruptured aortic aneurysm;
• severe damage or rupture of the uterine (fallopian) tube during an ectopic pregnancy;
• ruptures of cysts of internal organs;
• ovarian apoplexy;
• long-term use of drugs that reduce blood clotting (fibrinolytics or anticoagulants);
• diseases associated with significant decline blood clotting (these include such as hemorrhagic diathesis, obstructive jaundice, malaria).

Symptoms

Symptoms of intra-abdominal bleeding will depend on its intensity, location and size of damaged vessels or organs, as well as the nature of the damage. So, with minor bleeding, the manifestations will be blurry and unexpressed, and with strong and sudden bleeding, they will be obvious and sharp.

The following signs of hemoperitoneum are possible:

• general weakness, loss of strength, muscle atrophy;
• blanching of the mucous membranes of the skin;
• increased sweating;
• increased heart rate (sometimes up to 120 or even 140 beats per minute);
• dizziness;
• darkening in the eyes;
• fainting or shock state;
• soreness in the area of ​​the damaged organ (such pains are called abdominal pains, they are pronounced, they can radiate to the shoulders, chest, shoulder blades or back and force the patient to take a sitting position that alleviates the condition);
• loss of consciousness;
• the abdominal cavity is soft, not compacted.

For more information on symptoms and first aid, see the following video:

Diagnostics

If hemoperitoneum is suspected, the patient must be urgently taken to the hospital for staging accurate diagnosis and providing medical care. The specialist will examine the patient. On palpation, the doctor will determine possible character and localization of damage. But to clarify the diagnosis will require diagnostic procedures. Most complete picture reveal:

• ultrasound procedure,
• radiography,
• and diagnostic laparoscopy.

Blood tests can also be informative, allowing you to determine the level of hemoglobin (with blood loss, it will decrease), hematocrit and other indicators.

Treatment

If you suspect intra-abdominal bleeding the patient must be immediately laid on a flat horizontal surface. Movement before the arrival of doctors is contraindicated. Cold may be applied to the abdomen. The intake of liquids or food is strictly contraindicated.

Measures should be taken immediately and intensive care should be started. It includes resuscitation, anti-hemorrhagic and anti-shock measures:

• infusion administration of blood substitute solutions,
• the introduction of analeptics (these drugs have a stimulating effect on the vasomotor, as well as respiratory centers brain),
• reinfusion (collection of blood poured into the retroperitoneal space or abdominal cavity and its re-infusion).

Also, in most cases, surgical intervention is required, the purpose of which may be to restore the integrity or remove damaged organs, as well as ligation of blood vessels.

Complications

With significant blood loss, there is a risk of death. But even if the bleeding has stopped, an infection can develop, which in most cases leads to peritonitis - inflammation of the membranes that cover the internal organs and lining the abdominal cavity.

Prevention

To reduce the risk of developing intra-abdominal bleeding, you should undergo scheduled examinations on time and treat any diseases of the internal organs, as well as consult a doctor in case of injuries. It is extremely important to detect intra-abdominal bleeding in time and take the necessary measures.

Article publication date: 06/08/2017

Article last updated: 12/21/2018

From the article you will learn: what is internal bleeding, why it is dangerous and by what signs it is recognized. Types of internal bleeding and first aid algorithm.

Internal bleeding is an acute life-threatening condition in which blood flows out of the bloodstream or into the lumen through a rupture of the vessel wall. hollow organ(uterus, stomach, lungs) or into a cavity artificially created by the volume of leaked blood (for example, intermuscular space). This kind of bleeding is never isolated independent disease- but only either a sign or a consequence of the underlying pathological condition.

This pathology often develops as a result of trauma or chronic illness. Severe types of such bleeding with large blood loss (more than 1.5 liters) are very dangerous, can lead to lethal outcome. Bleeding with less blood loss (less than 1.5 liters) is still very serious. Spilled blood can compress nearby vessels, disrupt the functioning of internal organs, exit through the mouth, for example, when stomach bleeding, and be accompanied by other serious manifestations.

Internal bleeding is called due to the fact that the outflowing blood does not flow outside the body. Therefore, uterine, gastric or not always interpreted as internal; although given that blood sometimes does not immediately exit through the physiological openings - the mouth, anus, vagina - it is advisable to refer to them as internal.

The common causes, symptoms, and treatment of internal bleeding in men and women are the same.

A gynecologist deals with elimination, intestinal - a proctologist, pulmonary - a thoracic surgeon, post-traumatic - a traumatologist, intracranial - a neurosurgeon.

Untimely provision of medical care in case of a person’s late access to doctors or difficulties with differential diagnosis increase the risk to his health, and even life.

Types of internal bleeding

Internal bleeding is classified into many types, based on location, cause, time of occurrence, amount of blood loss, etc.

Causes of internal bleeding

Each type of bleeding has its own causes, the most common of which are injuries and illnesses in acute or chronic form.

Hemorrhage is provoked by:

1. Open and closed injuries the abdomen and lumbar region with damage or rupture of internal organs, more often the spleen or liver, less often the intestines and pancreas. Massive bleeding into the abdominal cavity is caused by a blow during a fight or during a car accident, compression pressure - when pressed with a heavy object, etc.
2. Fracture of the ribs leads to the outflow of blood into pleural cavity.
3. Traumatic brain injury. Bleeding inside the skull is life-threatening, because the volume cranium limited. Any hematoma leads to compression of brain structures and serious consequences. It can develop not only immediately after the injury, but also after a few hours or days after it.
4. chronic diseases digestive tract. Bleeding into the cavity of the corresponding organ occurs when, erosive gastritis cirrhosis of the liver, peptic ulcer, a malignant tumor process, the formation of a through hole with an ulcer of the 12 duodenal ulcer or stomach.
5. Gynecological diseases and pathological conditions- apoplexy (rupture) of the ovary, ectopic pregnancy, malignant neoplasm ruptured ovarian cyst. In obstetrics and gynecology uterine bleeding may induce abortion, presentation, or premature detachment placenta. It can start after childbirth due to a rupture birth canal or uterus, late delivery of the placenta.
6. Hemophilia - hereditary disease men with a failure of the blood coagulation process.

Symptoms

Symptoms depend on the amount of blood loss and its location. There are common signs and specific to a particular species.

Common symptoms of blood loss

Common signs of internal bleeding - the appearance of weakness, darkening or clouding in the eyes, drowsiness, dizziness, cold sweat, thirst. Loss of consciousness is not ruled out. The intensity of blood loss is determined by the pulse rate, blood pressure and characteristic complaints of the patient.

• Small blood loss often does not manifest itself in any way, but in some, the pulse slightly quickens, decreases slightly arterial pressure(HELL).
• Manifestations of bleeding moderate: Heart rate up to 100 beats per minute, decrease in systolic pressure up to 80 mm Hg. Art., moderate shortness of breath, dry mouth, cold hands and feet, cold perspiration, dizziness, severe weakness, slow reactions, fainting.
• With severe blood loss, the symptoms are more pronounced. Note the fall in blood pressure more than 80 mm Hg. Art., tachycardia more than 110 beats per minute, shortness of breath, hand trembling, excruciating thirst against the background of a decrease in urine output, apathy. There may also be a sharp blanching of the mucous membranes and skin, cyanosis of the extremities and the area around the lips, clouding or loss of consciousness.
• Among clinical manifestations massive hemorrhage observed cyanosis of the skin and mucous membranes, confusion, delirium. sink inside eyeballs, facial features are sharpened, the pulse reaches 160 beats per minute, blood pressure drops to 60 mm Hg. Art.
• With fatal and absolutely fatal blood loss we are talking about life threatening. The pupils dilate, convulsions appear, the number of heart beats (bradycardia) sharply decreases to 2–10 beats per minute, breathing becomes agonal, urine is spontaneously excreted and stool. The patient falls into a coma, his skin is dry, pale with marble pattern. The result is agony, death.

Signs of hemothorax

Hemothorax is the entry of blood into the pleural cavity. In addition to general symptoms, it is manifested by sharp pain in problem area, difficulty in breathing, cough with frothy bloody sputum. On x-ray, the mediastinum (the space in the middle part chest cavity) is shifted towards the healthy lung.

Signs of uterine bleeding

Symptoms of internal bleeding in women may be pulling, bursting or sharp pains in the lower abdomen with irradiation to the lower back and anus, the urge to defecate, a feeling of swelling of the mucous membranes.

Signs of hemorrhage in the urinary and digestive organs

• tar-colored chair fetid odor- melena - speaks of bleeding from upper division intestines or other digestive organs.
• With a hemorrhage in the stomach, a person begins vomiting with blood clots, in the lumen of the duodenum 12 - it becomes the color of coffee grounds.
• Bleeding out hemorrhoids manifested by bright bloody discharge from the anus.
• The blood that got into renal area, urinary tract, comes out with urine - hematuria.

First aid for internal bleeding

With any type of internal blood loss, you should immediately call an ambulance. Although with mild blood loss, a person himself can reach medical institution and get help, but it’s better not to risk it, because it is not known whether the bleeding has stopped, whether the general condition will worsen further or not.

From the correctness of rendering first aid often depends on a person's life. Before the arrival of doctors, you need to put the patient, further actions to carry out only after taking them horizontal, and with hemothorax in a semi-sitting position. On the area of ​​​​the alleged source of the problem, focusing on complaints, put ice. Then, as soon as possible, transport the victim in this position to the nearest medical facility. institutions or wait for the ambulance to arrive.

It is strictly forbidden: to heat the bleeding area, to apply pressure bandage, insert candles, use a laxative, do an enema (for intestinal bleeding), offer painkillers and medicines that stimulate the heart.

Neglect of the above actions can lead to increased blood loss and death.

Stationary medical care

Based on symptoms and primary medical examination, presumably find out which organ was damaged, and the patient is hospitalized in the appropriate department. In the presence of objective symptoms a large loss of blood - in intensive care.

The main goals of treatment:

1. Stop bleeding.
2. Restoration of the lost volume of blood constantly circulating in the body (BCC).
3. Normalization of microcirculation.

Often, massive blood loss can be stopped by emergency surgery:

• with a stomach ulcer, it is resected - a part of it is removed along with the ulcer;
• with pneumothorax, a thoracotomy is performed - the chest is opened, the cause of bleeding is found and eliminated;
• with a hematoma in the cranial cavity, a trepanation is performed: through the holes made in the bones of the skull, the neurosurgeon gains access to the brain structures and the formed hematoma, from which he sucks the blood;
• in some cases, internal bleeding can be stopped by tamponade: for example, to tamponade a bronchus, a sterile gauze swab or a foam sponge.

To replenish the BCC, infusion solutions, blood substitutes, and blood products are administered intravenously. The remaining funds are used for their intended purpose.

The prognosis depends on the competent provision of pre-medical and timely medical care.

The materials are published for review and are not a prescription for treatment! We recommend that you contact a hematologist at your healthcare facility!

Internal bleeding is a situation in which heme is poured into the body cavity, as well as into the spaces between organs and tissues. Most diseases appear pain syndrome. With internal bleeding, this symptom is absent, and other signs do not appear immediately. This makes timely diagnosis difficult.

Symptoms of internal bleeding become noticeable only when significant damage has already been done to the health, which poses a great threat to the life of the sick person.

Provoking factors

Internal hemorrhage occurs either due to trauma or as a result of a chronic process.

Deadly post-traumatic internal bleeding of the abdomen develops when receiving blunt trauma when the liver or spleen, intestines or omentum are damaged.

With fractures of the ribs with injury to the pleura and blood vessels, pleural blood loss is manifested.

Cranio-cerebral injuries make internal bleeding of the skull probable.

Important! Blood with penetration into the joint cavity, which may be caused by a fracture or bruise, does not pose a clear threat to life, but causes significant harm to health.

The causes of chronic internal bleeding are erosion of the walls of blood vessels as a result of the development of neoplasms, chronic diseases such as ulcerative perforation of the intestine, gastritis, dilatation of the veins gulam, gynecological diseases: ovarium ruptures, ectopic pregnancy, graviditate and genus pathologies.

Symptoms and signs

To general symptoms intraorgan hemorrhages include:

• weakness and malaise
• fainting, dizziness,
• excessive pallor of the skin,
• apathy,
• lowering blood pressure,
• tachycardia.

Important! Internal bleeding threatens the possibility of developing a pre-shock state. They consider it a harbinger intense thirst, weakness, state of anxiety. The skin turns pale, cold, the pulse becomes frequent and thready, breathing is shallow and uneven.

Specific symptoms occur in connection with the place of bleeding and outflow of blood: into the chambers or into the tissues.

Signs of internal bleeding in the abdomen:

• bloating. It becomes painful, hard;
• blood in faeces.

Internal hemorrhage in the organs of urination is detected by the appearance of blood in the urine. With the accumulation of blood in the heart sac, symptoms of cardiac tamponade, cyanosis, and an increase in venous pressure appear.

The outflow of blood into the pleural cavity produces squeezing of the lung, which is detected by shortness of breath and confirmed by the absence of respiratory sounds during auscultation.

Isolation of scarlet heme from the anus indicates hemorrhoidal inflammation.

Types and signs of internal bleeding are presented in the table:

Diagnostic studies

If internal bleeding is suspected, the following general measures are taken:

• Detailed inspection. They check the pulse, pressure, listen to the chest, feel and tap the abdominal cavity.
• Hematological research.

Specific diagnostic methods are carried out, taking into account the preliminary diagnosis:

• rectal examination;
• esophagogastroduodenoscopy;
• colonoscopy;
• bronchoscopy;
• cystoscopy;
• sigmoidoscopy.

With hidden hemorrhages, pay attention to general syndrome internal bleeding: dizziness, weakness, hypotension, tachycardia, coldness and pallor of the skin.

Important! An objective sign of blood entering the lung is the disappearance lower bound organ on x-ray.

When diagnosing bleeding in the abdominal cavity, laparoscopy is used, and intracranial hematoma is identified by echoencephalography.

Primary Care

Important! The main thing is the fastest delivery of the patient to the clinic. The first aid is to provide rest.

Assuming the presence, the patient is provided with a semi-sitting position. When internal bleeding occurs elsewhere, prior to arrival emergency care the patient must be laid on a leveled surface, apply cold to the place possible bleeding. You can not apply heat and give medicines to support the heart.

Methods for stopping blood

Patients are admitted to the hospital. Choose a department according to the source of bleeding: traumatological, thoracic, neurosurgical, gynecological or general surgery. The first concern in the first stage is how to stop the bleeding.

The video shows how to give first aid

In some cases, tamponade helps. In others - cauterization of the bleeding place. However, most often it is required surgery under anesthesia.