Symptoms of internal bleeding
Author: Surgeon Denisov MM
In modern surgery, special attention is paid to internal bleeding. This is attributed to the fact that internal bleeding compared with the open is much harder to diagnose. And that means that medical care may be delayed. Internal is called bleeding, characterized by the outpouring of blood into the body's natural cavities or artificially created spaces.
Depending on the amount of bleeding, there are three degrees of bleeding: moderate, moderate and severe.
The main reasons include: rib fractures with rupture of the intercostal vessels and lung tissue damage, malignant neoplasms of internal organs, closed injuries of the liver, spleen, intestine, complications of diseases of the organs such as the esophagus (varicose veins), stomach and duodenum, liver, female genitalia.
Frequency of internal bleeding
The most common bleeding in the defeat of the gastrointestinal tract. Therefore it is necessary to get acquainted with the methods of emergency care of gastrointestinal bleeding . In total, there are about 20 diseases, the most significant and frequently encountered among them are: acute erosive gastritis and gastric cancer, esophageal varices, cirrhotic liver damage. In the case of stomach cancer, the risk of a decaying tumor. The only sign that allows the patient to suspect that something was wrong is a darkening of the feces, which occurs due to the coagulated blood contained in it. In the case of vomiting, the pulping masses, again due to coagulated blood, are the color of coffee grounds.
In some cases, it is necessary to distinguish bleeding from the esophagus, stomach from bleeding with damaged lung. In the case of lung pathology, frothy unchanged scarlet blood is secreted.
Diseases of the female reproductive system can also cause internal bleeding. The most common cause is tubal abortion. When the fallopian tube ruptures, blood accumulates in the abdominal cavity, creating a sense of tension and pressure in the pelvis, especially on the rectum. By the way bleeding from the anus is also quite common. In the future, the peritoneum is irritated with blood, which leads to the development of a state of shock, loss of consciousness, fainting. The pulse in this case becomes frequent and filiform. On examination revealed abdominal distension, delayed stools and gas. The patient becomes pale, covered with cold sweat.
In the case of accumulation of blood in the pleural cavity, the development of the so-called hemothorax occurs. The pleural cavity is an insignificant volume that separates the lungs from the chest. The reasons leading to the development of hemothorax include the following: falls from a height, injuries with damage to the ribs and intercostal vessels, knife wounds, lung cancer, lung abscesses (that is, the formation of ulcers in the lung tissue).
With the accumulation of blood in the pleural cavity, there is difficulty in breathing on inspiration and coughing, sharp pains in the chest, a violation of the general condition - dizziness, weakness, fainting, pallor of the skin, increased pulse and respiration, sweating. Percussion of the patient's chest reveals a shortening of the percussion sound over the affected half, weakening or complete absence of respiration. On the roentgenogram, it is possible to determine signs of a mediastinal shift towards a healthy lung.
Frequent damage to the joints is the development of hemarthrosis, which means the accumulation of blood in the joint cavity. There is a similar condition as a result of injury, less often with hemophilia, scurvy. Anemic symptom is expressed slightly in contrast to local symptoms. The clinic has three degrees. When hemarthrosis 1 degree there is a slight pain, the contours of the joint are slightly smoothed, the range of motion is not changed. In general, the volume of blood in the joint is up to 15 ml. Grade 2 is characterized by a pronounced pain syndrome, which is aggravated by exertion, smoothness of the joint is noted. There is an increase in the circumference of the affected joint by 1.5 - 3 cm compared with a healthy one. In the case of hemarthrosis of the knee joint, a patella bullying is observed. The blood content in the cavity is up to 100 ml. With grade 3 pain is acute, the outlines of the joint are completely changed. The circumference of the joint increases to 5 cm, sharply limited mobility. Blood volume - more than 100 ml.
Thus, there are signs of bleeding that occur in any case, regardless of the source of the bleeding. Early signs include: pallor of the skin and visible mucous membranes, cold sweat, general weakness, dizziness, blackening of the eyes, with lung lesions - cough with blood streaks, bloody vomiting or bloody diarrhea, symptoms of peritoneal irritation that occurs when the rupture of internal organs (spleen, liver, kidney).
In other words, bleeding leads to the development of anemia. In addition to these symptoms, anemia is manifested by increased pulse and hypotension, that is, a decrease in blood pressure. The changed parameters directly depend on the degree of blood loss: with moderate - the pulse is not more than 75 beats per minute, the systolic pressure decreases to 100 mm Hg. v .; with medium - pulse rises to 100 beats per minute, blood pressure decreases to 90-80 mm Hg. v .; with severe - the pulse rises to 120-140 beats per minute, the systolic blood pressure drops below 80 mm Hg. st.
An important point in confirming the diagnosis is to conduct laboratory blood tests. The analysis revealed a decrease in the number of red blood cells, hemoglobin and hematocrit fall.
When identifying such symptoms and diagnostic data, it is necessary to immediately identify the cause of the underlying disease and proceed with treatment. It should be remembered that the sooner the cause of internal bleeding is identified, the more effective and quick the healing process will be.
Author: Emergency Doctor Deryushev A.N.
Pulmonary hemorrhage is the discharge from the respiratory tract during coughing of pure blood or blood as an abundant impurity to sputum. Pulmonary hemorrhage is a serious and dangerous complication of various inflammatory, specific or nonspecific respiratory diseases, as well as malignant tumors and lung damage.
Nasal bleeding frequency ranks first among spontaneous bleeding, and according to various sources, it makes up 3-5% of the total number of hospitalized in the ENT hospitals. If a child bleeds from the nose once, then there is nothing terrible about it. Without this, no one grows up. Another conversation, if blood goes time after time.
Gastric bleeding today is an urgent problem of emergency surgery. Accelerated pace of life, stress, irregular and poor-quality nutrition, uncontrolled intake of nonsteroidal anti-inflammatory drugs, gastric ulcer and duodenal ulcer, banal vomiting can lead to such a terrible complication. Bleeding from the upper digestive tract is most often associated with peptic ulcer or duodenal ulcer. In older people, the frequency of bleeding increases due to the use of nonsteroidal anti-inflammatory drugs.
Author: Emergency Doctor Deryushev A.N.
First aid for bleeding covers not only first aid for bleeding and wounds, but also fractures, including closed injuries. The medical definition of injury sounds like this - this is a sudden impact on the body of an external object that causes anatomical and functional impairment.