Internal bleeding

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Internal bleeding (also called internal hemorrhage) is a loss of blood that occurs from the vascular system into a body cavity or space.[1] It is a serious medical emergency and the extent of severity depends on bleeding rate and location of the bleeding (e.g. brain, stomach, lungs). It can potentially cause death and cardiac arrest if proper medical treatment is not received quickly.

Causes[edit]

A number of medical conditions may lead to internal bleeding. Common causes include trauma, various pathological conditions and complications of medical therapy. Common locations include the gastrointestinal tract, the aorta and intracranial hemorrhage.

Trauma[edit]

Internal bleeding can be caused by blunt trauma such as high speed deceleration in an automobile accident, or by penetrating trauma such as a ballistic or stab wound.[2]

Pathological conditions and disease[edit]

A number of pathological conditions and diseases can lead to internal bleeding. These include blood vessel rupture as a result of high blood pressure, aneurysms, esophageal varices or peptic ulcers.[3] Another common cause of internal bleeding is carcinoma (cancer), either of the gastro-intestinal tract, of the lung, or more rarely of other organs such as the prostate, pancreas or kidney.[3] Other diseases linked to internal bleeding include scurvy, hepatoma, liver cancer, Autoimmune Thrombocytopenia, ectopic pregnancy, malignant hypothermia, ovarian cysts, Vitamin K Deficiency, and hemophilia and malaria. Some viruses may cause a type of internal bleeding called viral hemorrhagic fever, such as the Ebola, Dengue or Marburg viruses, but these are rare.[4]

Iatrogenic[edit]

Internal bleeding could be an iatrogenic artifact as a result of complications after surgical operations or medical treatment. Some medication effects may also lead to internal bleeding, such as the use of anticoagulant drugs or antiplatelet drugs in the treatment of coronary artery disease.[5]

Prognosis[edit]

Internal bleeding is serious for two reasons:

  • the excess blood can compress organs and cause their dysfunction (as can occur in hematoma)
  • when the bleeding does not stop spontaneously, the loss of blood will cause hemorrhagic shock, which can lead to brain damage and death.

If there is pressure, it may lead to death or a brain hemorrhage.

Terminology[edit]

Cases of internal bleeding are usually termed as hemorrhage, even though the term is general to all kinds of bleeding. A minor case of internal bleeding results in ecchymosis, or a bruise: blood expands under the skin, causing discoloration.

Notes[edit]

  1. ^ Taber, Clarence Wilbur; Venes, Donald (2009). Taber's cyclopedic medical dictionary. F a Davis Co. p. 1200. ISBN 0-8036-1559-0. 
  2. ^ Nicholas S. Duncan, Chris Moran, "Initial resuscitation of the trauma victim", Orthopaedics and Trauma, Volume 24, Issue 1, February 2010, Pages 1–8
  3. ^ a b Edward W. Lee, Jeanne M. Laberge, "Differential Diagnosis of Gastrointestinal Bleeding", Techniques in Vascular and Interventional Radiology, Volume 7, Issue 3, September 2004, Pages 112–122
  4. ^ M. Bray, "Hemorrhagic Fever Viruses", Encyclopedia of Microbiology (Third Edition) 2009, Pages 339–353
  5. ^ Jan Pospisil, Milan Hromadka, Ivo Bernat, Richard Rokyta, "STEMI—The importance of balance between antithrombotic treatment and bleeding risk", Thrombosis , Volume 55, Issue 2, April 2013, Pages e135–e146