Intra-abdominal bleeding. What are the main symptoms of intra-abdominal bleeding in women?

Health may deteriorate unexpectedly. And strange pain in the area abdominal cavity lead to unbearable pain. What was the reason is difficult to say at first. But bleeding into the abdominal cavity is so dangerous that without diagnosing and treating it in a timely manner, a person can die.

The patient may not even suspect that he has internal bleeding in the abdominal cavity. Although it is almost always preceded by serious injuries, under the influence of which blood vessels are separated or simply damaged. Experts highlight the internal traumatic injury vessels. Thus, under the influence of a strong impact, mechanical separation occurs. The deformed vessel begins to bleed. As a result serious problems that need to be addressed as quickly as possible.

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

One of the main problems with 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, the progression of which may result in internal bleeding, he should know in advance about potential problems from his attending physician.

Bleeding into the abdominal cavity: symptoms

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

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

• A sharp decline blood pressure, accompanied by congestion in the ears and unbearable headache.
• Darkening of the eyes with temporary loss of consciousness. Fainting state.
• Chills and severe 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 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 abdominal cavity

If you pay close attention to your health, you can independently notice the main signs of internal bleeding in the abdominal cavity. Symptoms begin to become more severe, and the general condition worsens. But a lot depends on which vessel was damaged and at what speed the bleeding occurs. If it is bleeding rapidly and damaged large vessels, then a person can lose consciousness very quickly. With minor bleeding, the symptoms will only increase, and the person will become slightly worse. In such cases, the problem can be diagnosed much faster and treatment carried out 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 each of them in more detail:

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

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

As sad as it is to admit, 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 your life, forever.

Bleeding in the abdominal cavity has the following causes:

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

We must always remember 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 may even personally understand that his current changes are caused by active stage course of the disease.

Treatment of bleeding into the abdominal cavity

It is very important to properly treat bleeding into the abdominal cavity. First of all, if the patient complains of even a slight malaise and has characteristic symptoms, then you should immediately put him on a bed or other surface. Being in horizontal position Depending on where the pain is localized, it is necessary to apply cooling heating pads. Under no circumstances should they be removed before the ambulance arrives. 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.

In case of active and severe blood loss, immediate surgical intervention in parallel with maintenance therapy.

It must be remembered that treatment of bleeding into the abdominal cavity should be carried out on an inpatient basis 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 alert in order to understand in a timely manner what his ailment is and take appropriate measures.

Diagnosis of bleeding into the abdominal cavity

A patient with suspected bleeding into the abdominal cavity is subject to urgent examination in a hospital. The abdominal area is examined to identify characteristic signs of injury (open wounds, abrasions, bruises).

Superficial palpation reveals softness and slight soreness of the anterior abdominal wall, its limited participation in breathing, and mild symptoms of peritoneal irritation. Deep palpation is carried out carefully, as it causes sharp pain in the area of ​​the damaged organ or the entire abdominal wall. Percussion of the abdomen in the presence of bleeding into the abdominal cavity is very painful; due to the accumulation of blood, dullness of sound is noted in sloping areas. Auscultation of the abdomen reveals a decrease in bowel sounds. When a hollow organ ruptures, local manifestations of bleeding into the abdominal cavity may be masked by signs of incipient peritonitis.

Digital rectal and vaginal examination detect bulging and sharp pain in the anterior wall of the rectum and posterior arch vagina. If a disturbed tubal pregnancy is suspected, puncture of the abdominal cavity through the wall of the posterior vaginal fornix is ​​of great diagnostic importance.

Laboratory blood test with bleeding into the abdominal cavity, it shows an increasing decrease in the level of hemoglobin, the number of red blood cells and hematocrit.

Survey radiography in case of internal bleeding, it helps to determine the presence of free fluid (blood) in the abdominal cavity. With ultrasound of the pelvic organs and Abdominal ultrasound the source of bleeding in the internal organs and the accumulation of anechoic fluid are identified. The main methods for diagnosing bleeding in the abdominal cavity are endoscopic examinations - laparocentesis (puncture of the abdominal cavity with the connection of a groping catheter) and diagnostic laparoscopy.

Differential diagnosis bleeding into the abdominal cavity is carried out with perforated gastric ulcer And duodenum, retroperitoneal hematoma and hematoma of the anterior abdominal wall. If necessary, narrow specialists are involved in diagnostics - gynecologist, traumatologist,thoracic surgeon, coloproctologist, hematologist, etc.

65.Dynamic indicators for diagnosing ongoing bleeding

Signs of ongoing bleeding are increasing weakness, drowsiness, thirst, dizziness, blurred vision in the form of flashing “spots”, and blurred vision. The victim complains of cold even in warm weather. Nausea is common. The skin turns pale, the mucous membranes of the lips become bluish and dry, the tongue is dry. Fainting may occur, and with massive and rapid blood loss, confusion may occur. The pulse quickens and becomes weak and tense. Blood pressure progressively decreases. Shortness of breath appears.

These symptoms indicate the development of hemorrhagic shock in the victim due to blood loss.

66.Hemarthrosis

Hemarthrosis- hemorrhage in the joint. It occurs due to rupture of blood vessels supplying blood to intra-articular structures. Most often observed in the knee joint. May be traumatic or non-traumatic. Traumatic hemarthrosis always develops with intra-articular fractures and often accompanies milder injuries (tears and ruptures of ligaments, meniscus tears, joint bruises). Non-traumatic hemarthrosis can appear in diseases associated with blood clotting disorders or increased fragility vascular wall– for scurvy, hemophilia and hemorrhagic diathesis. With hemarthrosis, the joint increases in volume and becomes spherical, pain and fluctuation (swelling) occurs. Diagnosis is made based on examination. To clarify the cause of hemarthrosis, radiography, MRI, CT and other studies may be prescribed. Treatment– puncture of the joint and application of a plaster cast.

Such bleeding can be suspected only by changes general condition the victim and according to the symptoms of fluid accumulation in a particular cavity.

Bleeding into the abdominal cavity is manifested by pallor, weak rapid pulse, thirst, drowsiness, darkening of the eyes, fainting. If there is bleeding in chest cavity these symptoms are combined with shortness of breath.

When bleeding into the cranial cavity, signs of compression of the brain come to the fore - headache, impaired consciousness, breathing disorders, paralysis, etc.

IN modern surgery Special attention given to internal bleeding. This is due to the fact that internal bleeding is much more difficult to diagnose compared to open bleeding. This means that the medical assistance provided may be delayed. Internal bleeding is characterized by the outpouring of blood into the natural cavities of the body or artificially created spaces.

Depending on the amount of blood shed, there are three degrees of bleeding: moderate, moderate and severe.

The main causes include: rib fractures with rupture of intercostal vessels and damage lung tissue, malignant neoplasms internal organs, closed damage liver, spleen, intestines, complications of diseases of organs such as the esophagus (with varicose veins), stomach and duodenum, liver, female genitals.

Main signs of internal bleeding:

• Sticky cold sweat
• Pallor
• Shallow breathing
• Pulse is frequent and weak

Signs and symptoms that are not so pronounced and may only become apparent after some time:

• Blue skin discoloration (hematoma formation in the area of ​​injury)
• Soft fabrics painful, swollen, or hard to the touch
• The victim feels nervous or restless
• Rapid weak pulse rapid breathing, nausea or vomiting, decreased level of consciousness
• Pale skin, cool or damp to the touch
• Feeling of unquenchable thirst
• Bleeding from natural orifices of the body (nose, mouth, etc.)

First aid for internal bleeding:

• Provide complete rest
• Place the victim in a semi-sitting position
• Apply ice or cold water
• Urgently transport the victim to a surgical hospital

Frequency of internal bleeding

Bleeding most often occurs when the gastrointestinal tract is affected. Therefore, it is worth getting acquainted with the methods emergency care gastrointestinal bleeding. In total, there are about 20 diseases, the most significant and common among which are: acute erosive gastritis and stomach cancer varicose veins esophageal veins, cirrhotic liver disease. In the case of stomach cancer, the danger is a disintegrating tumor. The only sign that allows the patient to suspect something is wrong is the darkening of the stool, which occurs due to the coagulated blood contained in it. If vomiting occurs, the vomited masses, again due to coagulated blood, have the color of coffee grounds.

Symptoms of internal bleeding depend on its location and the degree of blood loss. In some cases, it is necessary to distinguish bleeding from the esophagus or stomach from bleeding from a damaged lung. When lung pathology foamy, unchanged scarlet blood is released.

Diseases of the female reproductive system can also cause internal bleeding. Most common cause is a tubal abortion. When breaking fallopian tube blood accumulates in the abdominal cavity, creating a feeling of tension and some pressure in the pelvis, especially on the rectum. By the way, bleeding from anus is also quite common. Subsequently, irritation of the peritoneum with blood occurs, which leads to the development state of shock, loss of consciousness, fainting. The pulse in this case becomes frequent and thread-like. Upon examination, abdominal bloating, stool and gas retention are revealed. The patient becomes pale and covered in cold sweat.

Symptoms of hemothorax (blood in the chest)

How to identify and recognize internal bleeding in the chest? If blood accumulates in pleural cavity the development of so-called hemothorax occurs. The pleural cavity is a small space 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, stab wounds, lung cancer, lung abscesses(that is, the formation of abscesses in the lung tissue).

When blood accumulates in the pleural cavity, difficulty breathing occurs when inhaling and when coughing, sharp pains in the chest, a violation of the general condition - dizziness, weakness, fainting, pallor of the skin, increased heart rate and breathing, sweating. When percussing the patient’s chest, a shortening of the percussion sound over the affected half is revealed, a weakening or complete absence breathing. On an x-ray, it is possible to determine signs of mediastinal displacement towards the healthy lung.

Hemarthrosis (blood in the joint cavity)

A common joint lesion is the development of hemarthrosis, which means the accumulation of blood in the joint cavity. Arises similar condition as a result of injury, less often with hemophilia, scurvy. The anemic symptom is expressed insignificantly, in contrast to local symptoms. The clinic distinguishes three degrees. With hemarthrosis of the 1st degree, it is noted mild 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. 2nd degree is characterized by pronounced pain syndrome, which intensifies with loads, smoothness of the joint is noted. There is an increase in the circumference of the affected joint by 1.5 - 3 cm compared to a healthy one. In case of hemarthrosis knee joint Balloting of the patella is observed. The blood content in the cavity is up to 100 ml. At grade 3, the pain syndrome is acute, the outlines of the joint are completely changed. The joint's circumference increases to 5 cm, and mobility is severely limited. Blood volume is more than 100 ml.

General symptoms

Thus, there are signs of bleeding that occur in any case, regardless of the source of the bleeding. Early signs include: pale skin and visible mucous membranes, cold sweat, general weakness, dizziness, darkening of the eyes, if the lungs are affected - cough with streaks of blood, if organs are involved in the process digestive system- bloody vomiting or bloody diarrhea, symptoms of peritoneal irritation, which occurs when internal organs (spleen, liver, kidney) rupture. With moderate bleeding, a number of symptoms may be either mild or not appear at all

In other words, bleeding leads to the development of anemia. In addition to the above symptoms, anemia is manifested by increased heart rate and hypotension, that is, a decrease in blood pressure. The changed parameters directly depend on the degree of blood loss: with moderate - pulse no more than 75 beats per minute, systolic pressure decreases to 100 mmHg. Art.; with average - the pulse rises to 100 beats per minute, blood pressure decreases to 90-80 mm Hg. Art.; in severe cases, the pulse rises to 120-140 beats per minute, systolic blood pressure drops below 80 mm Hg. Art.

Diagnostics

In case of combined trauma, laparocentesis is performed; it is a simple, fast, affordable and gentle method for diagnosing injuries to the abdominal organs and internal bleeding. An ultrasound of the abdominal organs is also sometimes performed.

An important point in confirming the diagnosis is laboratory research blood. The analysis reveals a decrease in the number of red blood cells, the amount of hemoglobin and a drop in hematocrit.

If such symptoms and diagnostic data are detected, it is necessary to immediately identify the cause of the underlying disease and begin treatment. It should be remembered that the earlier the cause of internal bleeding is identified, the more effective and rapid the recovery process will be.

Internal bleeding is one of the most dangerous species bleeding requiring immediate hospitalization.

Blood in the abdominal cavity is called hemoperitoneum, or internal abdominal bleeding. Internal bleeding is one of the most dangerous types of hemorrhage. It can be hidden, when it occurs in the body cavity, or obvious, which can be easily determined during examination.

Abdominal bleeding is most often parenchymal, when the integrity of the liver, pancreas, kidneys or spleen is damaged. Such bleeding is profuse and life-threatening. The second most common type of bleeding is mixed. It occurs when the veins and arteries of parenchymal organs are damaged.

Causes of bleeding in the abdominal cavity

Internal bleeding is caused by mechanical injuries internal organs. It could be swipe, gunshot wound or stab wound, striking parenchymal organ. Another reason may be a complication of diseases of internal organs, such as tumors of various origins, ectopic pregnancy, splenic rupture or cyst. How to know that internal hemorrhage has begun:

• The skin and mucous membranes turn pale.
• Dizziness begins and general weakness in the body is felt.
• Blood pressure drops sharply.
• An attack of tachycardia (rapid heartbeat) begins.
• The pain in the abdominal area intensifies and can radiate to the shoulder blade, shoulder and back.
• There is loss of consciousness.

If the symptoms coincide, call immediately ambulance. Bleeding in the abdominal cavity is very dangerous. The patient needs urgent hospitalization and careful diagnosis followed by treatment.

Diagnosis of abdominal bleeding

IN in case of emergency when internal bleeding is obvious, the patient is given first aid medical care to temporarily stop the bleeding before hospitalization. The final stop carried out already in the operating room. If the patient only has a suspicion of internal bleeding, then a thorough diagnosis is performed:

• Examination of the skin for the presence open wounds, bruises, bruises.
• Palpation is superficial and deeper. Superficial palpation allows you to determine the softness of the anterior wall of the peritoneum and its soreness. Deep is performed very carefully, as it can cause severe pain.
• Rectal and vaginal examination determines rectal tenderness or excludes the possibility of ectopic pregnancy.
• will determine which organ is damaged and caused bleeding, and will also show the presence of accumulated fluid in the peritoneum.
• X-rays determine the presence of blood in the abdominal cavity.
• Diagnostic laparoscopy provides accurate information about the damaged organ. Can be used in cases where other diagnostic methods cannot provide an accurate picture of the disease. Can be used even when the patient is unconscious. To date, this is the most accurate and reliable method diagnosis of diseases of internal organs.

You will also need to donate blood for general analysis. It will be very informative and will help determine the level of hemoglobin, and with blood loss it usually decreases and you need to monitor its condition, and will also show the amount of hematocrit and red blood cells.

Treatment of abdominal bleeding

During heavy bleeding and at sharp decline blood pressure, blood substitutes are transfused and analeptics are administered.

To completely stop the bleeding, surgery is indicated to eliminate damage to internal organs.

The materials are published for informational purposes only and are not a prescription for treatment! We recommend that you consult a hematologist at your medical institution!

Internal bleeding is a situation in which heme is poured into the body cavities, as well as into the spaces between organs and tissues. Most diseases manifest themselves as pain. 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 caused to the health, posing a great threat to the life of the patient.

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.

For rib fractures with pleural injury and blood vessels, pleural blood loss appears.

Craniocerebral injuries make internal bleeding of the skull likely.

Important! Blood entering 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 perforations of the intestines, gastra, dilation of the gulam veins, gynecological diseases: ovarium ruptures, ectopic pregnancy, graviditate and genus pathologies.

Symptoms and signs

TO general symptoms hemorrhages inside organs include:

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

Important! Internal bleeding threatens the possibility of developing a pre-shock state. His harbingers are considered extreme thirst, weakness, state of anxiety. The skin turns pale and cold, the pulse becomes rapid and thready, breathing becomes shallow and uneven.

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

Signs of internal bleeding in the abdominal cavity:

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

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

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

The release of scarlet heme from the anus indicates hemorrhoidal inflammation.

The types and signs of internal bleeding are presented in the table:

Diagnostic tests

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

• Detailed inspection. Check pulse, blood pressure, listen chest, palpate and tap the abdominal cavity.
• Hematological studies.

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

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

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

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

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

Primary care

Important! The main thing is to get the patient to the clinic as quickly as possible. First aid is to ensure peace.

If the presence is assumed, the patient is provided with a semi-sitting position. When internal bleeding occurs in other places, before emergency help arrives, the patient should be laid on a leveled surface and cold applied to the area possible bleeding. Do not apply heat or give medications to support the heart.

Methods to stop bleeding

Patients are hospitalized in a hospital. Select a department based on the source of bleeding: traumatology, thoracic, neurosurgical, gynecological or general surgery. The first concern at the first stage is how to stop the bleeding.

The video shows how to provide first aid

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