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.
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| hematoma contusion |
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.
Hematoma causes
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
- Size
- 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.

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