Hematoma

Not to be confused withHaematommaorHemangioma.

Ahematoma,also spelledhaematoma,orblood suffusionis a localizedbleedingoutside ofblood vessels,due to either disease or trauma including injury or surgeryand may involve blood continuing to seep from brokencapillaries.A hematoma isbenignand is initially in liquid form spread among the tissues including in sacs between tissues where it maycoagulateand solidify before blood is reabsorbed into blood vessels. Anecchymosisis a hematoma of the skin larger than 10 mm.

Hematoma
Other names	haematoma
Contusion(bruise), a simple form of hematoma
Specialty	Emergency medicine

They may occur among and or within many areas such asskinand otherorgans,connective tissues,bone,jointsandmuscle.

A collection of blood (or even ahemorrhage) may be aggravated byanticoagulantmedication (blood thinner). Blood seepage and collection of blood may occur ifheparinis given via anintramuscularroute; to avoid this, heparin must be givenintravenouslyorsubcutaneously.

Signs and symptoms

Intramuscular hematoma development and progression on thevastus lateralis musclefrom 6 hours after trauma to 86 hours

Some hematomas are visible under the surface of the skin (commonly called bruises) or possibly felt as masses or lumps. Lumps may be caused by the limitation of the blood to a sac,subcutaneousor intramuscular tissue space isolated by fascial planes. This is a key anatomical feature that helps prevent injuries from causing massive blood loss. In most cases a hematoma as a sac of blood eventually dissolves; however, in some cases it may continue to grow due to blood seepage or show no change. If the sac of blood does not disappear, then it may need to be surgically cleaned out or repaired.

The slow process of reabsorption of hematomas can allow the broken down blood cells and hemoglobin pigment to move in the connective tissue. For example, a patient who injures the base of their thumb might cause a hematoma, which will slowly move all through their finger within a week.Gravityis the main determinant of this process.

Hematomas onarticulationscan reduce mobility of a member and present roughly the same symptoms as afracture.

In most cases, movement and exercise of the affected muscle is the best way to introduce the collection back into the bloodstream.

A misdiagnosis of a hematoma in the vertebra can sometimes occur; this is correctly called ahemangioma(buildup of cells) or a benign tumor.

Classification

Types

Intramuscular hematoma atbuttocksas a result of asports injury

Left to right: Epidural, subdural, and intracranial hematoma of the brain

Hematoma of the ankle caused by a 3rd degreesprain

• Subdermal hematoma (under theskin)
• Intramuscular hematoma (insidemuscle tissue)
• Skull/brain:
  • Subgaleal hematoma– between thegalea aponeurosisandperiosteum
  • Cephalohematoma– between theperiosteumandskull.Commonly caused by vacuum delivery and vertex delivery.
  • Epidural hematoma– between theskullanddura mater
  • Subdural hematoma– between thedura materandarachnoid mater
  • Subarachnoid hematoma– between thearachnoid materandpia mater(thesubarachnoid space)
  • Othematoma– between the skin and the layers of cartilage of the ear
• Breast hematoma(breast)
• Perichondral hematoma(ear)
• Perianal hematoma(anus)
• Subungual hematoma(nail)
• Rectus sheath hematoma

Degrees

• Petechiae– small pinpoint hematomas less than 3 mm in diameter
• Purpura(purple) – a bruise about 3–5 mm in diameter, generally round in shape
• Ecchymosis– subcutaneous extravasation of blood in a thin layer under the skin, i.e. bruising or "black and blue", over 1 cm in diameter

Etymology

The English word "hematoma" came into use in 1826. The word derives from theGreekαἷμαhaima"blood" and -ωμα-oma,a suffix forming nouns indicating a mass or tumor.

See also

• Metanephric dysplastic hematoma of the sacral region
• Welts

External links

• Media related toHematomasat Wikimedia Commons