A hematoma is a localized collection of blood that forms outside of blood vessels, usually due to trauma or injury. It occurs when damaged blood vessel walls allow blood to leak into surrounding tissues. While many small hematomas resolve on their own, some may require medical attention.
What is a Hematoma?
A hematoma is a collection of blood that escapes from a damaged blood vessel and gathers in a confined space within the body, often after an impact or injury. Unlike a bruise, which is a flat discoloration from tiny capillary leakage, a hematoma involves a larger pooling of blood and often appears as a raised, firm, or spongy mass.
Hematomas can occur anywhere, including under the skin (subcutaneous), within muscles, or beneath a fingernail or toenail (subungual). Internal hematomas, such as those in organs or body cavities, are not visible externally. The body’s natural healing process involves reabsorbing the collected blood over time, causing the hematoma to gradually shrink and fade.
Deciding on Drainage: Key Considerations
Medical professionals consider several factors when deciding whether to drain a hematoma or allow it to heal naturally. The size and location of the hematoma play a significant role. Large or expanding hematomas can exert pressure on surrounding tissues, causing pain, blocking blood flow, or impairing function. Hematomas located in sensitive or enclosed areas, such as the brain or near major nerves, are often more concerning.
The symptoms a person experiences also guide the decision. If a hematoma causes significant pain not relieved by conservative measures, or leads to nerve compression resulting in numbness, tingling, or weakness, drainage may be necessary. Functional impairment, such as restricted movement in a joint due to a large hematoma, can also indicate a need for intervention. Intracranial hematomas, such as those in the brain, require urgent attention due to the limited space within the skull and the risk of brain compression.
Potential complications exist if a large hematoma is left undrained. These include an increased risk of infection, calcification forming a hardened mass, or persistent pressure and long-term scarring. Patient factors, such as age, overall health, and the use of blood-thinning medications, also influence the decision, as these can affect bleeding risk and healing capacity.
The Drainage Process and Associated Risks
When drainage is necessary, it is a medical procedure performed by a healthcare professional. Common methods include needle aspiration, using a syringe and needle to draw out accumulated blood, or incision and drainage, which involves making a small cut to allow blood to escape. The choice of method often depends on the hematoma’s size, location, and consistency.
Any drainage procedure carries inherent risks. These include the potential for infection, especially if the procedure is not performed in a sterile environment. There is also a risk of increased bleeding during or after drainage, particularly for individuals with underlying bleeding disorders or those on blood-thinning medications. Nerve damage, scarring, and the chance of the hematoma recurring due to ongoing bleeding or inadequate removal are additional considerations. Attempting to drain a hematoma at home without medical supervision is strongly discouraged due to these risks.
Recognizing When Professional Help is Needed
Knowing when to seek professional medical help for a hematoma is important. You should consult a doctor if the hematoma rapidly grows in size or if the pain becomes severe and worsens over time. Signs of infection, such as increasing redness, warmth, swelling, or the presence of pus around the site, along with a fever, warrant immediate medical evaluation.
Any hematoma accompanied by neurological symptoms like numbness, tingling, weakness, confusion, dizziness, or loss of consciousness, particularly after a head injury, requires urgent medical attention. Loss of function or movement in the affected area is also a concerning sign. Furthermore, hematomas appearing in unusual or sensitive locations, such as near the eye or in the groin, or those that do not show signs of improvement or worsen over time, should be assessed by a healthcare provider.