Definition of the hematoma
Hematoma is a collection of blood, more or less abundant, located outside of blood vessels. Blood, escaped from the circulatory system after trauma or bruising, focuses on a tissue or in the body cavity hematoma, and thus originated a hematoma.
The term comes from the Greek hematoma: the root "hemat" means "blood", while the suffix-oma ( from soma) means "body".
The hematoma may develop in differnt areas of the body: within a muscle, under the skin's surface, in the head or in the brain, ear, anal region or under the nail.
The hematoma itself must be distinguished from bruising and ecchymosis (or: Hemangioma Livid): is a kind of minor hematoma, characterized by the spread of blood under the skin (the blood transfer is limited): Hemangioma is an abnormal buildup of blood vessels in the skin or internal organs. It is precisely in a cancer form in which blood vessels proliferate in the endothelium.
In the hematoma, blood is coagulated totally or partially, depending on the time elapsed since the bleeding. The blood that comes from the damaged subcutaneous capillaries, pours into the underlying tissue, where there remains stucked; not finding way out, blood originates a typical red spot on the skin, or a hematoma.
The are many causes :
- Hematoma bleeding,alteration: some defects of blood coagulation capacity-such as hemophilia or thrombocytopenia may encourage the formation of haematomas. In such circumstances, may cause small pseudo-hematoma (rather bruising) even after small traumas. The same symptom can be found in patients taking medicines antithrombotic, like coumadin.
- Surgery: the hematoma is one of the most common complications that occur after some surgical procedures. A hypertensive patient, undergoing a surgery, it is more exposed to the risk of bruising.
- Injury to blood vessels already altered by pathological disorders such as aneurysms, infections and cancers, leukemia, anticoagulant therapy: heparin administration or dicoumarol trauma, bruises, barrel: after the rupture of a blood vessel, blood accumulates in the tissue or damaged organ, becomes more dense and originates the hematoma.
The hematoma may involve any body structure; the severity of injury depends on the type of trauma, the size of the hematoma and, above all, to the anatomical seat in which manifests itself.
Often, simply to bump against an object can break the capillaries and create a small hematoma: it is easy to understand that, in similar circumstances, the hematoma does not need some medical urgency. In other circumstances, a severe contusion may cause a deep and extensive damage, so the bleeding created takes on a completely different meaning from previous situation.
Severity of hematoma depends on:
- Blood vessel damaged
- Amount of trauma
- Fabric characteristics that form the hematoma
- Efficiency of coagulative capacity
- Seniors develop bruises more easily than young: indeed, as age progresses, blood vessels become more fragile and thin, thus more vulnerable to rupture.
Hematoma characteristic symptoms
Symptoms of hematoma vary according to the severity of the trauma suffered. For example, a small skin hematoma can produce relatively light symptoms , PAIN/TENSION of the affected area and FEELING of WARMTH. Minor hematoma of this type don't need any medical intervention.
Typical hematomas "superficial" is the variation of colours. Initially, the bruise appears reddish; After a few days, the hematoma becomes bluish/purplish coloration, sometimes black. After about a week, the hematoma is dressed in yellow-green and, after a couple of weeks, disappears completely.
The change of the colours of the hematoma is due to transformation of EME (prosthetic group of emoglobima) in bilirubin, bile pigment orange-yellow color derived from catabolism of RBCs Some hematomas may even go unnoticed: the case of the classics "household incident", where the bump against an object can cause a micro-hematoma (a rupture of small blood vessels).
Tottaly different and more dangeours is mild to severe trauma such as a cerebral hematoma, which involves a complex and impressive manifestations, requires urgent and immediate action.
To understand the severity of a hematoma, we distinguish two cases:
- The hematoma will spontaneously auto-resolve: typical condition of small hematomas, involving capillaries or small-caliber vessels. The accumulated blood coagulates tissue and, slowly, is reabsorbed.
- The hematoma volume increases: when the hematoma involves high-caliber blood vessels (e.g. arteries) bleeding tends to persist, and the lesion is not able to auto-resolve. The arteries are just predisposed to spontaneous hemostasis, therefore the hematoma volume increases. In these cases, medical intervention is needed to avoid possible devastation.