The hallmark of parenchymal bleeding is that the person loses a large amount of blood. By itself, the outpouring of blood will not stop, so the victim needs emergency help.

What organs are called parenchymal?

The main function of these organs is blood purification. In this regard, they have a fleshy parenchyma. These organs remove waste products from the blood. This category includes:

1. Liver. This organ processes harmful substances that enter the blood.
2. Kidneys. Through these organs, excess fluid, toxins and other metabolic products are excreted from the body along with urine.
3. Lungs. Participate in the process of gas exchange.
4. Spleen. In the tissues of this organ, the death of blood cells that have already served their purpose occurs.

These organs are very delicate, they are actively supplied with blood, since their functions are associated with its purification and processing. Any damage to these organs leads to an outpouring of blood.

Causes

What can cause bleeding? Parenchymal hemorrhage may result from:

1. Injury. If one of the above organs is damaged, bleeding (parenchymal) may begin. The causes of injuries can be very different, including falls, blows, injuries during accidents or accidents.

If a person has a blood clotting disorder, then it will be more difficult to stop the bleeding. This happens in people with certain congenital diseases. Also, poor clotting appears with age or while taking drugs that thin the blood. Such drugs, by the way, are often prescribed to patients with cardiac diseases.

What does the process of hemorrhage look like in the body?

Parenchymal bleeding is bleeding in which there is an outflow (into the external environment or into any cavity inside the body) of blood from the vessel. The cavity between the layers of tissues, which is filled with blood, is called a hematoma. Outwardly, on the body, this is easy to notice.

When a vessel is damaged, parenchymal bleeding begins. In the beginning, you can ignore it. The symptoms that the patient describes can be confused with other pathologies. And it is often difficult to assume that a person has parenchymal bleeding.

Stopping blood loss on your own in this case is impossible. Only medical attention is needed. If it is not provided, then over time a person develops anemia. With such a disease in the blood, the number of red blood cells decreases and the level of hemoglobin falls. In this state, there is insufficient nutrition of other organs of the human body. Namely, the brain and heart suffer most from hypoxia.

With a large blood loss, a person develops hemorrhagic shock. This condition is considered severe. The patient has a decrease in pressure and develops multiple organ failure. If blood loss is rapid, then cardiac arrest and death are possible.

Parenchymal bleeding. signs

As mentioned above, it happens that the signs of this condition can be confused with other diseases. Usually bleeding is accompanied by general weakness. The person begins to feel dizzy, he may lose consciousness. The appearance worsens, the skin becomes pale and cold. On the forearm, the pulse is poorly palpable. The heart rate increases and the blood pressure is very low.

There are capillary and parenchymal bleeding. Of course, the latter are the most dangerous. You can distinguish individual symptoms depending on the affected organ:

1. Features of parenchymal hemorrhage of the liver. This organ is located on the right side, under the ribs. As a rule, the liver is affected in people who have hepatitis or are addicted to alcohol. Also susceptible to parenchymal bleeding of the liver are those who have had a disease such as malaria. The ailments listed above cause an increase in the volume of the liver, resulting in stretching of the capsule and tissue damage. Blood begins to pour into the abdominal cavity. That's where the bile comes out. This leads to the development of such a pathology as biliary peritonitis. A person with this type of bleeding has severe pain in the abdomen, signs of shock appear. Subsequently, a subcapsular hematoma may occur.
2. Features of parenchymal bleeding of the kidneys. The reason for it may be a strong physical impact on the kidneys of a person (for example, a blow). Signs include severe pain in the lumbar region. Also, in a patient with such bleeding, the urine turns red. This phenomenon is called macrohematuria. If an oncological disease develops in the body, then this type of bleeding can be prolonged and lead to anemia.
3. Features of parenchymal bleeding of the lungs. Damage can be caused by trauma, tuberculosis, or cancer. Usually with such bleeding, pulmonary insufficiency develops. Often there is an accumulation of blood in the pleural cavity, which increases the pressure on the lung.
4. Features of parenchymal bleeding of the spleen. Damage to this organ is a threat to human life. With this type of bleeding, subcapsular ruptures of the spleen are formed. Acute blood loss is not always observed immediately after injury, it can develop after a few days. There are statistics that confirm that the spleen is often injured in childhood.

Main symptoms for all types

What signs indicate that there is internal bleeding in the body?

First of all, you need to carefully look at the work of the body if a person has been injured in the abdomen, chest or lower back. Symptoms include:

1. The presence of hematomas on the body or fractures of the ribs.
2. Complaints of the patient about pain in possible areas of bleeding, general weakness of the body.
3. Deterioration of a person's appearance, namely, pallor of the skin, the appearance of cold sweat. Facial features become sharp.
4. Rapid heartbeat, low blood pressure.

Help

If a person has signs that indicate internal bleeding, then he must be urgently taken to the department of surgery. The usual methods of stopping, which include the application of a tourniquet, will not help in this case. A real help to a patient with internal bleeding can be provided by a surgeon on the operating table. There are several recommendations on how to behave if there is a suspicion that a person has a parenchymal injury (bleeding). Assistance to the patient should be provided in the following order:

1. It is recommended to ensure the horizontal position of the victim, the legs should be raised up.
2. Ice should be applied to the site of the alleged bleeding.

The task of the ambulance team is to deliver the patient to the hospital and administer drugs that will help stop the bleeding. Also, a person is given medications that maintain normal blood pressure.

How is the surgical treatment carried out?

In order to diagnose bleeding, the patient is given an ultrasound and X-ray of the internal organs. If the diagnosis is confirmed, then an emergency surgical operation is prescribed.

There are several ways to stop bleeding.

1. Use of a hemostatic sponge.
2. Hemming of the seal.
3. Resection (removal) of any part of the organ.
4. Electrocoagulation (cauterization) of blood vessels.
5. Embolization.
6. The imposition of special complex sutures on the vessels.

The patient is also given a blood transfusion.

What to do in this case?

If there is a suspicion of parenchymal bleeding, first aid is to call an ambulance. It should be understood that this type of outpouring of blood will not go away on its own. Therefore, at the slightest suspicion, you should immediately call the doctors and go to the surgical hospital.

There, an accurate diagnosis will be made and an emergency operation will be performed. Any delay can lead to the death of a person. It is important to monitor the state of the body and well-being, especially if any injuries have been received in which organs such as the liver, lungs, kidneys and spleen could be damaged.

Also, the presence of hematomas and smudges on the body, pain and dizziness should alert a person and force him to seek qualified help from specialists. It is good if there are relatives or people nearby who are able to provide assistance.

It is important to provide the patient with physical peace and emotional support.

Conclusion

Now you know what parenchymal bleeding is, how it manifests itself and what needs to be done in this situation. We hope that the information provided in the article was useful to you. It is worth recalling once again that you should not even try to cope with parenchymal bleeding on your own.

Parenchymal bleeding: why it occurs

Since this type of blood loss is quite serious and dangerous, many people have a natural question: under what injuries can it appear? Consider the main reasons for this trouble:

If you suffer from any of the above, you need to be especially careful about your body, as cases of sudden bleeding are possible.

The mechanism of blood loss and the main signs

Parenchymal bleeding is the release of vital fluid from the vessel into the external environment or internal cavities. Particularly copious discharge
occur as a result of trauma or injury. There is no way to stop this process on your own, so you should immediately consult a doctor. But this immediately raises the question: how to detect blood loss? There are several symptoms of this trouble:

• sudden loss of consciousness;
• dizziness;
• severe weakness;
• pallor;
• cardiopalmus.

Of course, according to these indicators, it is difficult to recognize exactly parenchymal bleeding, since they are quite extensive. Therefore, it is important to know other, more characteristic signs:

1. No pulse in forearm.
2. Severely low blood pressure.
3. Pain in the organ that provokes trouble.
4. The appearance of red tints in the urine.
5. Hard breath.
6. Cold sweat.

With these symptoms, you should immediately call an ambulance, because the faster qualified assistance is provided, the less time the treatment will take and there will be more chances for a successful cure. In addition, the reasons for emergency care are severe hematomas on the body and bruising. After receiving an injury of any degree, it is necessary to go to the doctor, since the absence of pain and noticeable external damage may indicate internal bleeding.

First aid for parenchymal bleeding

First aid in this case consists in promptly calling an ambulance or delivering the victim to the nearest medical facility. However, while waiting for doctors, you should also not waste time in vain, since performing certain actions can alleviate the patient's condition. So, if you are next to a person who is suspected to have internal bleeding, in particular parenchymal, you should:

1. First, calm down the victim and calm down himself, so that there is no panic, hysteria and unnecessary worries.
2. Next, it should be, if possible, laid in a horizontal position, placing 1-2 pillows under your feet.
3. If you roughly know which organ caused the trouble, apply cold to it.
4. Never shake a person or give him medicines.

Upon arrival, the ambulance must necessarily take the victim to the hospital, where he will be treated in a stationary mode. He will be injected with special drugs that will reduce the loss of vital fluid. Of course, they will not completely stop it, but they will significantly reduce the outflow. Next, an infusion of saline into a vein will begin to maintain blood pressure. Until the patient completely stops parenchymal bleeding, he will not be able to leave the medical facility.

Parenchymal bleeding is bleeding in which blood is not released to the outside, but due to damage to internal organs or some of their pathologies, it flows into the internal cavities of the body (abdominal, pleural).

Types of bleeding

Bleeding is the outflow of blood from the vessels. Most often, it is caused by damage to them. This may be the result of an injury (which happens most often) or the consequences of pathological changes in the body. Such a "melting" of blood vessels can be observed in tuberculosis, oncological conditions, and ulcers of internal organs.

Bleeding is usually divided into external, when blood from a damaged vessel pours out through a wound or natural openings, and internal. In this case, blood accumulates in the cavities. There are the following types of external bleeding:

• capillary - arise as a result of superficial damage, blood is released in small quantities, drop by drop;
• venous - occurs as a result of deeper injuries (cut, stab wounds), while a large amount of dark red blood flows out;
• arterial - the cause is deep damage in which the wall of the arteries is damaged, while the blood is poured out in a pulsating stream and has a bright scarlet color;
• mixed bleeding can also occur with deep injuries, while both arteries and veins bleed in the wound at the same time.

Internal bleeding

Despite the obvious danger to the patient's life, such bleeding is not always possible to identify immediately. It often happens that blood loss occurs for some time, with little effect on overall well-being. Parenchymal bleeding in the early stages can be suspected by general weakness, drowsiness, dizziness. The patient is thirsty, "flies" and darkening in the eyes, cold sweat. Possible fainting. About can be judged by factors such as pulse, blood pressure and other objective signs.

With a slight blood loss, a slight decrease in pressure and an increase in heart rate (up to 80-90 beats per minute) are possible. In some cases, it generally disappears without obvious signs, which creates an even greater danger, since parenchymal bleeding cannot stop on its own.

Moderate blood loss is characterized by an increase in heart rate to 100 beats per minute or more and a decrease in systolic pressure below 90 mm Hg. Art. rapid breathing, pallor of the skin, cold clammy sweat, cold extremities, dry mouth, severe weakness, apathy, adynamia, mental retardation are also noted.

In the event of severe blood loss, systolic pressure falls below 80 mm and the pulse rate may exceed 110 beats per minute. Breathing is superficial, greatly accelerated, yawning, pathological drowsiness, tremor of the hands, a decrease in the amount of urine excreted, severe pallor, marbling of the skin, lethargy or confusion, excruciating thirst, cyanosis of the extremities, acrocyanosis are observed.

Life-threatening bleeding

Massive internal bleeding is characterized by a decrease in pressure up to 60 and an increase in heart rate up to 140-160 beats per minute. Cheyne-Stokes breathing (respiratory movements first deepen and become more frequent, but at 5-7 breaths their intensity begins to decrease, after which there is a pause). or absent, delirium, the skin is sharply pale, sometimes with a grayish tint. Facial features are sharpened, eyes sunken.

Fatal blood loss (as a rule, it is a third of the volume, that is, 1.5-2 liters) is accompanied by the development of a coma. In this case, the pressure drops below 60 mm or is not detected at all, pulse contractions slow down to 2-10 beats, convulsions are observed, agonal breathing, the pupils are dilated, the skin is dry, “marble”. As a rule, such a condition is irreversible - agony inevitably ensues, and then death.

Everyone knows very well that very often timely first aid can save a patient's life. Unfortunately, the same cannot be said for internal bleeding. Parenchymal bleeding cannot be stopped or reduced by improvised means, the most important thing that can be done for the victim is to deliver him to the surgical hospital as soon as possible, that is, call an ambulance.

To prevent the patient's condition from worsening, before she arrives, you can provide the following assistance for parenchymal bleeding:

• to give the victim a horizontal position, with raised legs if hemorrhage in the abdominal cavity is possible, or a semi-sitting position if hemothorax is suspected;
• place cold on the area of ​​​​the alleged bleeding.

Note! Patients with symptoms of internal bleeding are strictly forbidden to warm the diseased area, provoke vomiting or do enemas and give drugs that stimulate cardiac activity.

Treatment

To date, the only way to stop parenchymal bleeding is surgery. As a rule, this happens during an emergency operation, before which laboratory tests are performed that evaluate hematocrit, hemoglobin and erythrocyte levels, do an ultrasound of the abdominal cavity, x-rays.

There are several ways to stop parenchymal bleeding. This:

• organ resection;
• drying of the stuffing box;
• electrocoagulation of blood vessels;
• suturing of blood vessels;
• embolization of the feeding vessel;
• usage

Along with stopping bleeding, the most important task is to compensate for blood loss, restore the volume of circulating fluid and improve microcirculation. For this purpose, transfusion of blood, plasma and blood substitutes is carried out, as well as the administration of a 5% glucose solution, saline.

Parenchymal bleeding, as a rule, is accompanied by a large blood loss and will not stop without emergency surgery. Consider the main features of this type of blood loss.

Parenchymal organs

The peculiarity of parenchymal organs is that they have a "fleshy" and abundantly supplied with blood parenchyma. This is due to their functional purpose - blood purification and removal of metabolic products from it.

Parenchymal organs include:

• liver (participates in the processing of harmful substances, taking blood through the portal vein);
• kidneys (excrete metabolic products with the urine they form);
• lungs (they exchange gases and release carbon dioxide into the atmosphere);
• spleen (destroys spent blood cells and participates in its deposition).

The figure shows a feature of the structure of the liver parenchyma

Parenchymal organs consist of delicate tissue and are richly supplied with blood. Even a minor injury to them can lead to internal bleeding.

The situation is aggravated by congenital and acquired problems with the blood coagulation system.

The mechanism of blood loss and changes in the body

Bleeding is the outflow of blood from a vessel into the external environment or internal cavities of the body. Impregnation of surrounding tissues with blood is called hemorrhage. A cavity formed in the tissue and filled with blood is a hematoma.

In case of injury, cyst rupture or tumor necrosis, the wound surface begins to bleed profusely. This bleeding will not stop on its own. The structural feature of the parenchyma is such that the walls of the vessels are fused with the stroma and do not collapse.

Blood flows out of the vascular bed through the defect. At first, blood loss may not be noticed, since we do not see blood, and general complaints can correspond to a large number of other diseases. Gradual blood loss leads to anemia.

As a result of a decrease in erythrocytes and hemoglobin in the blood, internal organs, including the brain and heart, suffer from hypoxia. With abundant blood loss, hemorrhagic shock develops. This is a severe complication of severe bleeding, while there is a significant decrease in pressure with the subsequent development of multiple organ failure. Rapid blood loss can lead to cardiac arrest and death.

How to suspect

Signs of parenchymal bleeding can be erased, disguised as other diseases. Bleeding from the parenchyma of the liver, kidneys, lungs, spleen may have its own characteristics. Common symptoms are signs of acute blood loss. First of all, weakness, dizziness will disturb, loss of consciousness is possible. The skin becomes pale, cold. If you try to determine the pulse on the forearm, then it will be very poorly palpable, the so-called "filamentous pulse". The heart will beat faster. Blood pressure will be reduced, and may not be determined at all.

If shock is suspected, check the pulse

Features for each parenchymal organ

Along with the general signs of latent blood loss, each parenchymal organ may have its own symptoms.

Liver

It is located in the right hypochondrium. As a rule, the liver of people suffering from hepatitis, abusing alcohol, and recovering from malaria is more susceptible to damage. All these conditions lead to its increase and overstretching of the capsule. As a result of injury - "where it is weak, it breaks there." When the liver is injured, blood leaks into the abdominal cavity. Along with blood, bile also enters there, which provokes the development of biliary peritonitis subsequently. The pain syndrome, the phenomena of shock and internal bleeding prevail. Perhaps the development of subcapsular hematoma with subsequent rupture.

kidneys

Kidney injury can occur from a fairly strong impact. Bleeding may be accompanied by severe back pain and shock. A characteristic sign may be gross hematuria - urine staining red. In the presence of an oncological process, prolonged chronic blood loss is possible, leading to the development of severe anemia.

Lungs

Pulmonary bleeding is also parenchymal. It can be caused by trauma, oncology, tuberculosis. Clinically, it may manifest as respiratory failure. Blood can accumulate in the pleural cavity, thereby squeezing the lung.

Hemoptysis is one of the signs of pulmonary hemorrhage

Spleen

The spleen stores blood. If she is injured, life-threatening blood loss can develop. As in the liver, subcapsular ruptures can also form in the spleen. This kind of damage can be misleading. The clinic of acute blood loss will develop not after the injury, but after a few days, when, under the pressure of the blood bursting from the inside, the capsule bursts. Trauma to the spleen, unfortunately, is not uncommon in childhood.

How to suspect internal bleeding, what measures to take

What should be of concern:

• anamnesis (the presence of an injury to the abdomen, chest, lower back);
• visual examination (presence of hematomas, bruises, abrasions on the skin of the chest, abdomen, fracture of one or more ribs);
• complaints (pain in the area of ​​suspected bleeding, severe weakness);
• appearance (pale skin, cold sweat, pointed features);
• clinic (palpitations and low blood pressure).

In a hospital, an ultrasound of the abdominal cavity is done to diagnose an abdominal injury.

First aid for suspected internal bleeding is to deliver the patient as quickly as possible to the surgical hospital. Such methods of stopping bleeding, such as a tourniquet, a pressure bandage, do not work here. Only a surgeon in an operating room can provide real assistance and effectively stop the bleeding.

Before the ambulance arrives:

• put the victim horizontally with raised legs;
• put ice on the area of ​​suspected bleeding.

An ambulance transports the patient to the hospital, and also introduces special hemostatic drugs (etamsylate, vikasol, aminocaproic acid).

These measures will not stop bleeding, but blood loss may decrease slightly. EMTs will also infuse saline into the vein to maintain the falling blood pressure.

Surgery

The main assistance to the patient is provided in the operating room. For diagnostic purposes, preliminarily take tests, do an ultrasound of the abdominal cavity, X-ray of the lungs. Then an emergency operation is performed. With questionable data from diagnostic methods, diagnostic laparoscopy can begin.

Ways to stop parenchymal bleeding:

• hemostatic sponges;
• hemming of the omentum;
• resection of a part of an organ;
• electrocoagulation of the surface and vessels;
• embolization of the feeding vessel.
• special complex seams.

In parallel with the operation and after it, a blood transfusion and saline solutions are performed. Intensive therapy is aimed at preventing the development of DIC and multiple organ failure.

Parenchymal bleeding is a threat to life and health. Serious bleeding, which may be unrecognized and lead to large blood loss, will not stop on its own. Requires urgent surgical care. It is important to be very alert to the signs described above and seek immediate medical attention. In this situation, the account goes on hours, not even days.

The abdomen in the human body is the most unprotected area, injuries and bumps are common here, especially in adolescence. Most of them are not dangerous and do not require emergency medical intervention, but some have quite serious consequences. Trauma to internal organs with damage to the blood vessels is one of the most common causes of hospitalization. If parenchymal bleeding occurs during injury, and was not noticed and stopped in time, it carries the threat of complications, up to death.

What are parenchymal organs? These are organs, most of which do not have a cavity, the main tissue of which is abundantly supplied with a mesh. Parenchymal organs in humans are involved in vital processes in the body: in providing respiration, nourishing tissues, cleaning.

This group includes:

• lungs- the main supplier of oxygen and a utilizer of carbon dioxide, lung tissue provides gas exchange through a network of small capillaries and alveoli;
• liver- "factory" of blood purification from toxins formed in the process of splitting substances, in addition, it is involved in the production of certain enzymes;
• spleen- an important organ of hematopoiesis, along with the bone marrow, is a place of storage of young maturing and a place of utilization of cells that have worked out their time;
• pancreas- the main organ that produces insulin;
• The kidneys regulate the excretion of fluid and the decay products dissolved in it.

The main tissue of the parenchymal organs has a rich blood supply, and even the slightest injury can cause a massive one.

What are dangerous

With internal bleeding, an outpouring of blood occurs: into the surrounding tissue, into the cavity of the organ, into the free cavity (pleural, abdominal, pelvic). According to the affected vessel, there are: arterial, venous, capillary bleeding. For example, venous bleeding can occur when the portal vein of the liver is injured, it is characterized by a rapid increase in symptoms, massive blood loss, and the likelihood of developing hemorrhagic shock.

Reasons for development

• According to statistics, the main cause of vascular damage is trauma.
• that cause a violation of the integrity of tissues, such as tuberculosis.
• Malignant neoplasms in the last stage cause bleeding during the decay of the tumor.
• Benign neoplasms, in case of their rupture.

Each parenchymal organ has its own most common causes, signs and features of the development of bleeding.

The lungs are often injured by the sharp edges of the ribs when they are fractured. Therefore, if a rib fracture is suspected, tight bandaging is strictly contraindicated. Also a common cause is bleeding in tuberculosis and oncological diseases. The main symptoms of bleeding are hemoptysis, shortness of breath, and tightness in the chest.

Spleen. Teenagers are more susceptible to injuries of this organ. Often primary bleeding occurs under the capsule. Only a few days later, from overstretching, the capsule breaks, pouring the accumulated fluid into the cavity.

Injury to the pancreas is a rare phenomenon, as is bleeding itself, the main causes leading to damage to blood vessels are cysts and malignant tumors.

The kidneys are usually injured with a fairly strong blow or pressure, as well as when the cysts rupture. Bleeding of the kidneys is accompanied by a characteristic color of urine () and severe pain, it can occur both in the lumen of the organ and in the pelvic cavity.

Symptoms

The usual measures (pressing the vessel, applying a tourniquet) do not work in this case. The main task is to deliver the patient to the nearest medical facility as soon as possible.

Before the arrival of the ambulance, the person should be laid down, cold is applied to the alleged place of bleeding. To do this, you can use an ice pack, thermal packs, or a regular bottle of cold water. With a rapid decrease in blood pressure, the foot end is raised 30-40 centimeters above the level of the heart.

It is important to constantly control breathing and heart rate, if necessary, carry out resuscitation. It is contraindicated to give the victim any medicines, including painkillers, food and drink; if you are very thirsty, you can rinse your mouth with water.

When admitted to the hospital

In a hospital, the diagnosis consists of taking an anamnesis and an objective examination of the victim:

• an important point is the presence of a blunt trauma or penetrating wound of the chest, abdominal, pelvic cavities;
• probable infectious diseases or neoplasms;
• palpation and percussion examination;
• change in normative parameters - blood pressure, heart rate, body temperature.
• clinical examination reveals signs of acute blood loss.

If you suspect a lesion of the organs of the abdominal or pelvic cavity, ultrasound is of great help. If necessary, endoscopy is performed.

Medical assistance in a hospital setting

The final treatment, the fight against bleeding and the restoration of the lost blood volume, occurs in a hospital setting. Stopping parenchymal bleeding is not an easy task. Hemostatic drugs, such as vikasol and aminocaproic acid, do not have the desired effect. Usually it is necessary to resort to a surgical method of intervention, but even at the same time, the delicate tissue of the parenchyma often breaks through and bleeds.

As auxiliary methods, diathermocoagulation, application of hemostatic sponges, transfusion of whole donor blood, plasma and platelet mass are used. If it is impossible to suture the organ, its resection or removal is performed. Subsequently, the main task is to prevent the development of shock from acute blood loss, to restore the necessary circulating blood volume.

It is important to remember that parenchymal bleeding during injury is not able to stop on its own, and every lost hour and day worsens the condition of the victim and increases the risk of complications. Mixed bleeding is especially dangerous, which, if medical care is not provided in time, leads to death.