An abdominal haematoma is an internal bleeding event within the abdominal region. It involves a collection of blood that has escaped from blood vessels. This accumulation can affect various areas inside the abdominal cavity, posing a serious health concern.
Understanding Abdominal Haematomas
An abdominal haematoma is a localized pooling of blood outside blood vessels. This collection can form within abdominal wall muscles or deeper inside the abdominal cavity, including the retroperitoneal space. Blood may also accumulate within an organ’s covering, such as the liver or spleen, or freely within the intraperitoneal space. A haematoma forms when a blood vessel ruptures or leaks, allowing blood to accumulate and potentially exert pressure on surrounding tissues and organs.
Common Causes of Abdominal Haematomas
Abdominal haematomas can arise from traumatic or non-traumatic origins. Traumatic causes often involve external forces impacting the abdomen, such as blunt force trauma from vehicle accidents, falls, or direct impacts during sports. Penetrating trauma, like stab or gunshot wounds, also causes bleeding. Iatrogenic causes, resulting from medical procedures, include complications from surgeries, biopsies, or catheter insertions.
Non-traumatic causes include conditions that weaken blood vessels or impair clotting. Anticoagulant medications can significantly increase the risk of spontaneous bleeding. Underlying bleeding disorders also predispose individuals to haematoma formation. Ruptured aneurysms in abdominal arteries can cause sudden and significant internal bleeding. Certain medical conditions, including severe pancreatitis or a ruptured ectopic pregnancy, can lead to blood accumulation. In some instances, tumors may bleed internally, or the cause might not be immediately identifiable.
Key Symptoms to Recognize
Pain is a primary symptom, often sudden and severe, though it can also be a dull ache that gradually intensifies. The pain’s location typically correlates with the haematoma’s site, but it can also be generalized across the abdomen or radiate to other areas, such as the back or shoulder.
Changes in the abdomen’s physical appearance are common indicators. Patients may notice visible swelling or a distended abdomen. Tenderness to touch or palpation over the affected area is frequently reported. In some cases, a firm, localized mass may be felt within the abdominal wall or deeper inside.
Systemic signs of blood loss or hypovolemic shock signal a more severe internal bleed. These include pallor (noticeable paleness of the skin), generalized weakness, and profound fatigue. Dizziness, lightheadedness, and fainting can occur due to decreased blood supply to the brain. The heart compensates by beating faster (tachycardia), while blood pressure drops (hypotension). Confusion or altered mental status may develop in severe cases.
Other associated symptoms vary depending on the haematoma’s specific location and size. Nausea and vomiting may occur, particularly if the haematoma is pressing on digestive organs. Changes in bowel habits, such as constipation or diarrhea, might also be experienced. For a retroperitoneal haematoma, flank pain or pain radiating to the groin can be prominent. The onset of these symptoms can range from acute and immediate following an injury to more gradual, developing over several hours or days.
When to Seek Urgent Medical Care
An abdominal haematoma is a serious medical condition requiring immediate attention. Anyone experiencing severe, sudden abdominal pain, especially after an injury or without clear cause, should seek emergency medical evaluation. Signs of shock, such as profound dizziness, a rapid heart rate, or fainting, indicate significant internal bleeding and require immediate emergency services. Any sudden, unexplained swelling or distension of the abdomen warrants an emergency room visit.
Even if symptoms are less acute, certain signs should prompt a medical evaluation. Persistent or worsening abdominal pain that does not resolve should be assessed by a healthcare professional. Unexplained bruising or swelling in the abdominal area requires investigation. This is especially true for individuals taking anticoagulant medications, as their risk of internal bleeding is elevated. Those with known bleeding disorders also need to be vigilant for such symptoms.
A medical professional can accurately diagnose an abdominal haematoma. Diagnosis involves a clinical assessment, physical examination, and imaging studies like ultrasound, CT scans, or MRI. These tools help determine the haematoma’s location, size, and whether it is actively bleeding. Timely diagnosis allows for appropriate management, ranging from conservative monitoring to surgical intervention.