One of the most insidious acute life-threatening conditions is internal bleeding. They represent pathological condition, accompanied by the release of blood from the vessels into the free abdominal cavity, retroperitoneal space or hollow organs (stomach and intestines). The whole complexity of the situation is that usually most diseases cause concern in a person in connection with a signaling pain syndrome. With any bleeding, there are no such signs. This leaves this problem long unnoticed. They begin to pay attention to it only when the condition of patients deteriorates sharply. But there are specific symptoms of internal bleeding, the knowledge of which can help in timely diagnosis this difficult problem.

Signs of internal bleeding

way attentive attitude to all changes in the body, you can notice, at first glance, ordinary changes. Over time, they gradually worsen. Immediate signs of internal bleeding:

1. Poor health and general weakness;
2. Dizziness and fainting;
3. Drowsiness and apathy (lack of interest in anything);
4. Unnatural pallor skin;
5. A decrease in blood pressure below those figures that are typical for a particular person at normal times ( arterial hypotension);
6. Increased heart rate (tachycardia).

All of the above symptoms are common. They are characteristic of any type of internal bleeding. There is another group clinical manifestations, which refer to the specific features of a particular type of this disease. About them we will talk in other sections of the article.

The only thing worth dwelling on is the rate of development and progression of symptoms. Sometimes all signs increase so quickly and spontaneously that neither the patients themselves nor the people around them can understand what is happening. But it happens that the situation develops gradually with a gradual violation of the general condition and worsening of symptoms. This option clinical course internal bleeding is more favorable, as it makes it possible to notice threatening symptoms and seek help in a timely manner.

The intensity of internal bleeding and the rate of increase of its symptoms depends on the cause of its occurrence and the diameter of the bleeding vessels. The larger the vessel is damaged, the heavier it is!

Types of internal bleeding and their manifestations

If we consider this issue globally, then we can say that internal bleeding is one in which the outflowing blood does not have direct contact with external environment. Therefore, many do not classify bleeding from the stomach and intestines as internal. But, given that they may not cause specific symptoms for a long time, it is advisable to consider them in the context of internal ones. After all, the main thing is to suspect a problem as early as possible, and everything else will be clarified in the process of observation and diagnosis in a medical institution.

All types of internal bleeding and the corresponding specific symptoms shown in a visual table.

Type of bleeding	How to identify internal bleeding
Bleeding into the free abdominal cavity (tears internal organs: liver, spleen)	General symptoms (weakness, dizziness, pale skin, arterial hypotension and tachycardia); Heaviness in the abdomen; Symptom "Vanka-vstanka" - the appearance of pain in the right or left shoulder, neck in a horizontal position. Sitting the pain goes away, but dizziness occurs; Soreness upper divisions abdomen on palpation.
Bleeding from pelvic organs(ruptures of the ovaries, uterus and fallopian tubes)	General symptoms; Pain and discomfort in the lower abdomen; Pressure on the anus; Soreness over the bosom on palpation; Symptom "Roly-Vstanka" occurs only with massive bleeding and severe general condition of patients.
Bleeding into the retroperitoneal space (ruptures of the abdominal aorta, kidneys and adrenal glands)	Symptoms general. Always expressed moderately; Lower back pain; A positive symptom of tapping - tapping on the lower back causes increased pain.
Gastrointestinal bleeding (diseases of the stomach, small and large intestines, leading to exposure of blood vessels)	Bright general symptoms; Vomiting blood or brown contents (coffee grounds); Bloody diarrhea, dark cherry or black stools; The absence of any pain in a stomach.

Laparoscopy is the most modern method diagnosis and treatment of internal bleeding

Immediate causes of occurrence

The following diseases and conditions can lead to internal bleeding:

1. closed and open injuries abdomen with damage to internal organs (liver, spleen, mesentery of the small intestine);
2. Ovarian apoplexy (ruptured ovaries);
3. Rupture of an ovarian or pelvic cyst (most often occurs during sexual intercourse);
4. Active physical exercise(may provoke ruptures of cystic ovaries or enlarged internal organs);
5. Injuries of the lumbar region;
6. Aortic aneurysms that begin to dissect
7. peptic ulcer duodenum and stomach;
8. Ruptures of the mucous membrane of the esophagus (Malory-Weiss syndrome);
9. and stomach;
10. Decaying tumors gastrointestinal tract, abdominal cavity and retroperitoneal space.

Internal bleeding can never be independent disease. They are always either the main manifestation or a complication of a number of pathological conditions.

What is the danger and what to do

It is very important to know how to behave in case of internal bleeding. After all, a person's life often depends on it. Undifferentiated tactics are reduced to the following activities:

1. Put the patient to bed with the slightest signs of internal bleeding. Everything next steps must be performed strictly in the horizontal position of the patient;
2. Abdominal cooling (ice pack or cold heating pad on the lower abdomen, hypochondrium or lumbar region, depending on the presumed localization of the source of bleeding);
3. Transportation of the patient in this position to the nearest medical institution.

If you neglect the rules of first aid, this can lead to increased bleeding and massive blood loss. Such conditions are always very dangerous and pose a direct threat to human life.

In conditions surgical hospital specialists can choose the following tactics.

Situation	What actions
Insignificant bleeding with signs of its independent stop and moderate blood loss. The diagnostics did not reveal severe injuries and there is no significant accumulation of blood in the abdominal cavity.	Observation, infusion therapy intravenous administration saline solutions(Ringer, saline, rheosorbilact, refortan), hemostatic drugs (aminocaproic acid, etamsylate).
Severe blood loss of any origin, regardless of the causes of occurrence and damage to organs	Emergency operation with parallel infusion therapy to maintain the most important vital parameters.

In the vast majority of cases of internal bleeding, urgent surgical treatment. This is the only way to save lives and prevent complications.

Opened internal bleeding is a condition that is dangerous to health and life, which occurs due to different reasons. Most often, blood penetrates into the cavities of the body, as well as the spaces formed by it.

Internal bleeding - what is it?

This is a rapid loss of blood, in which it does not flow out of the body, but enters into certain places inside. This may be the uterus in women, the space between the joints, the stomach, bladder, lungs, intestines.

Symptoms given state depends on its location. Hemorrhage can occur in the abdominal cavity, intermuscular, etc.

The causes of pathology are, as a rule, of two types: mechanical damage (trauma, impact) and chronic illness.

The danger of such a phenomenon is enhanced by untimely first aid, ignoring signs to patients, and late diagnosis.

If you seek medical help in time, you can minimize serious complications, determine the location of bleeding and stop it.

Symptoms of pathology

Intra-abdominal bleeding is one of the most common mechanical injuries. The symptoms of this form are quite serious.

The patient is very sick, bloody vomiting opens, if the pathology is in the gastrointestinal tract. Diarrhea occurs when there is internal bleeding in the upper esophagus or small intestine. With a lesion in the large intestine, red discharge will be from the anus.

Gastrointestinal bleeding is one of the most dangerous. Symptoms include fever, the patient may feel pain in the abdomen. If, then a person is tormented by a strong bloody cough, and the place of accumulation of secretions is the pleural cavity. There is shortness of breath, not enough air.

At uterine blood goes in the middle of the cycle, pours out of the vagina. However, many symptoms in a number of species are not pronounced, which makes it difficult to diagnostic measures and worsen the patient's condition.

So, the symptoms of bleeding that occurred inside the body:

1. Deterioration of well-being.
2. Sudden weakness, lethargy, apathy.
3. Chills, fever, fever, sweating, pallor.
4. Acute feeling of fear.
5. Nausea, vomiting.
6. Thirst.
7. Loss of self control.
8. Dizziness, fainting.
9. Severe cough with blood.
10. Dyspnea.
11. sudden pain inside or their complete absence.

If no one is around, you need to call the ambulance service, then take a horizontal position. If possible, you should also call your loved ones, if they are nearby. In this case, being alone is not only scary, but also dangerous..

You can not take any pills, drink water. It is necessary to apply ice to the head, chest, stomach. It is important to try not to panic and not make sudden movements.

Common signs of bleeding

The main signs for all forms of bleeding that have occurred inside the body are: weakness in the body, lethargy, arterial pressure(BP) is significantly reduced, the skin turns pale, appears cold sweat.

A suspicion of such a condition should arise if there were provoking factors (shocks with blunt, stabbing objects; injuries), diseases of the internal organs were diagnosed.

The patient may lose his appetite, feel intense thirst even lose consciousness. How severe a person's condition can be recognized by certain signs.

If the bleeding is insignificant, then the pulse is intense - up to 80 beats per minute, and blood pressure decreases, the rest of the symptoms may be absent.

If bleeding medium degree, top pressure drops to 90 mm. rt. Art. and below, the heart rate increases. In this case, the skin turns pale, hands and feet become cold, breathing quickens, nausea, weakness, dizziness appear, all psychomotor reactions slow down.

In severe cases, the patient's pressure drops significantly, the pulse speeds up, intermittent breathing, cold sweat appears, drowsiness appears, trembling of the hands and feet, it darkens in the eyes, vomiting begins, the skin turns pale, cyanosis develops, the person's condition is critical.

If the blood loss is massive, then the pressure drops sharply, the pulse is very fast - up to 160 beats per minute, the patient's consciousness is confused, pale skin, delirium, cold sweat are observed, facial features are sharpened.

Fatal blood loss: slow pulse, low blood pressure, respiratory arrest, convulsions, dilated pupils, dry and pale skin, agony and death.

Kinds

There are several types of bleeding: arterial, capillary, venous. The cause of arterial - damage to the artery with a sharp, cutting object, gunshot wound; injury resulting from a blunt blow.

It is very difficult to stop bleeding on your own. Blood is poured into the organs and out in a fountain, the victim can lose a critical volume of blood in a few minutes, which will lead to death.

Capillary - common. In this case, the surface of the internal organs may bleed, these include the liver, kidneys, spleen.

Symptoms at the very beginning are mild, which complicates the diagnostic process. A stomach ulcer can cause it, and hemorrhage occurs in the brain tissue. In this case, it is urgent to provide assistance to the patient.

Venous is formed if the walls of the veins are damaged. The patient instantly develops symptoms of anemia, anemia, and a state of shock occurs. At venous bleeding may occur dangerous states, in which the outgoing fluid accumulates in the pleural and retroperitoneal cavities.

Causes

Why does such a pathology occur? The factors of its formation can be different, at first glance, even impossible. Among them:

• poor blood clotting (heredity);
• rib fractures, mechanical injuries, wounds;
• infections, pathologies, liver cirrhosis, ulcers, tuberculosis, improper location of internal organs, their displacement, increase due to illness;
• during pregnancy - rupture of the ovary, cysts, ectopic location of the fetal egg;
• decay malignant tumor;
• arterial hypertension, atherosclerosis.

There can be many more reasons, so it is important to respond in time to sudden changes in well-being, especially if there were provoking factors, and also diagnosed chronic diseases intestines, stomach and other vital organs.

Methods for determining the location of internal damage

If a person is ill, how to find an objective sign of internal bleeding and recognize its source?

If a hemorrhage occurred in the abdominal cavity, followed by a rupture of the spleen or liver, then common symptoms include dizziness, weakness, low blood pressure and tachycardia. The patient develops heaviness in the abdomen, pain in the left and right shoulder, palpation of the peritoneum has pain in the upper part.

It is difficult to determine the bleeding and its nature on its own, but it is possible.

If there is a rupture of the pipes or ovaries, then there is pain in the lower abdomen, in the anus, deterioration of health, there is red discharge from the genitals.

With bleeding that occurred in the retroperitoneal space (ruptures of the kidneys, aorta), the patient has general symptoms, not very pronounced.

Feeling pain in lumbar If you knock lightly on the spine, then it will intensify.

If the lesion is in the stomach, intestines, then there is hematemesis or diarrhea, no pain in the abdomen.

How to stop bleeding

If there is a suspicion of internal hemorrhage, then the first health care play at home important role for the outcome of the situation. Before the doctors arrive, the patient should be laid down so that the muscles relax. If the victim has a cough, then his body is given a semi-sitting position.

Be sure to open the window in the room, apply cold to the alleged damage site.

It is important to control a person's breathing, pulse. If he gets worse, you need to do and carry out artificial respiration.

You can not give painkillers, water, medicines, knead the body, tightly bandage the injury site, move the victim.

Drug therapy

The best treatment for internal hemorrhages is timely assistance and surgery. Therapy of this pathology is carried out in a hospital, in the departments of gynecology, surgery, neurosurgery - depending on the source of blood loss.

Doctors first stop the blood, compensate for its loss, improve circulation. Use physical solutions, glucose, the rest medical preparations assigned according to the condition of the patient.

When is an operation required?

Surgical intervention is necessary if the patient's condition is critical. After the person was given first aid, he was hospitalized. Specialists take into account the source of bleeding, and then take action.

If the place of fluid concentration is the pleural cavity, then traumatologists are involved in the treatment, if the lungs - surgeons, with intracranial damage - neurosurgeons, with uterine damage - gynecologists.

Surgery will be required if the source is in the gastrointestinal tract.

The main task of the doctor is to stop bleeding, compensate for the volume of loss and improve blood supply. Patients often experience shock, in which the internal organs receive less oxygen.

In such cases, patients are given a transfusion, glucose and saline are administered. If the case is severe, the bleeding is stopped by cauterization, but surgery is most often required.

With pulmonary hemorrhage, tamponade of the bronchus is performed. If filled with blood abdominal part then an immediate laparotomy is performed. If the damage is intracranial, then trepanation is done. With an ulcer, damaged vessels are removed, with cracks in the intestine, an operation is performed and they are sutured.

If a woman has an ectopic pregnancy (a tube rupture has occurred), then the pathology is eliminated only by surgery.

Internal bleeding during pregnancy

This state is also called premature detachment placenta, and it requires urgent specialist intervention.

Clinical manifestations of this condition:

• discharge can be plentiful, medium, absent altogether;
• pain in the lower abdomen, the uterus "hardens", it is easy to feel it on palpation;
• the cardiac activity of the fetus is disturbed, hypoxia occurs (determined by ultrasound);
• the woman's body temperature rises.
• feeling worse.

Provoke detachment maternal alcohol consumption, drug addiction, smoking, anemia, low red blood cell count, abdominal trauma, allergy to medications, fluctuations in blood pressure.

Consequences

Any bleeding poses a threat to a person, and internal bleeding is even more so. In this state, blood pressure suddenly drops, hemoglobin decreases.

If blood enters the cavities of the internal organs, their activity is disrupted. If at the same time the vessels are compressed, then tissue necrosis occurs. Blood that is in the cavities of the organs for some time (not circulating) becomes a suitable place for the reproduction of bacteria and the development of infections.

If the patient was not provided with timely assistance, then there is a high probability of death. The body is bled, the activity of the heart and brain is disrupted. If a person manages to help, then he expects a long period recovery, and it all depends on the severity of the condition.

internal bleeding dangerous because it is impossible to independently determine the intensity and volume of blood loss.

First aid for internal bleeding is aimed at reducing blood loss and the possibility of transporting the victim to medical institution. This condition threatens the life of the patient, so you need to act quickly, following all the rules.

This type of bleeding occurs with injuries or diseases of the organs. It often occurs in the abdominal or thoracic region, as well as in organs, less often in large muscles.

Signs of internal bleeding depend on the location of its localization:

• Parenchymal organs - lungs, kidneys, liver and spleen. This is parenchymal bleeding. The symptoms of this species are blurred. signs parenchymal bleeding depend on the affected organ. When the lungs are affected, a cough with blood appears, the patient begins to suffocate, as edema of this organ develops. If the focus of blood loss is in the pleural region, then breathing quickens and the skin turns blue. With damage to the liver and kidneys, the patient is worried strong pain in the region of the organ.
• Abdominal cavity - symptoms of intoxication appear. The patient's blood pressure decreases, vomiting begins with blood, the skin turns pale. The patient becomes weak and may lose consciousness.
• Large muscles - abrasions and hematomas appear on the skin.

The most dangerous are the first two types of bleeding. Common symptoms for all groups are weakness, dizziness, decreased pulse and pale skin.

Parenchymal bleeding in the lungs

Urgent Action

IMPORTANT! Stop the bleeding at home will not work. Only surgeons can deal with this type of blood loss.

Algorithm for helping with internal bleeding

The first aid step by step looks like this:

Action	Description
	At the first symptoms, you need to call an ambulance.
	If there is blood loss in the abdominal cavity, lay the victim on his back, raise his legs above body level, tilt his head back.
	Apply ice to the damaged area.
	Give the patient hemostatic drugs, such as aminocaproic acid, Vikasol, Hemophobin. Be sure to tell the emergency doctor about this.

The blood after these actions will not stop, but the amount of blood loss will decrease.

Important! Forbidden

• Apply a tourniquet, pressure bandage;
• Put an enema;
• Warm up the damaged area;
• Give the victim laxatives and drugs that increase blood pressure and stimulate cardiac activity.

Instructions for parenchymal bleeding

For bleeding in the area chest it is necessary to transport the victim in a semi-sitting position. Place a cushion under your knees.

Rendering first aid looks similar, but there are some differences in how to transport the casualty.

• If blood is released from the lung, then you need to free the chest, forbid the victim to move, cough and talk.
• The patient should take a vertical position, it is best to transport him while sitting, put a roller under his knees and back.

In the video in this article more details about the symptoms and help to the patient.

• suturing the wound;
• vagotomy;
• organ resection;
• pleural puncture.

First aid for internal bleeding is vital, especially for parenchymal blood loss. Symptoms may be blurred at first, and symptoms appear when the life of the victim is in danger.

How doctors can help

Already in the ambulance, the victim is given hemostatic drugs, for example, Etamzilat or Hemophobin. To maintain blood pressure, saline is administered intravenously.

The patient is taken to the operating room, they take tests and do an ultrasound.

Parenchymal bleeding can be detected during ultrasound of the organs.

Medical stop of bleeding consists in such surgical actions:

• stitching, ligation or electrocoagulation of the vessel;
• use of a homeostatic sponge;
• suturing the wound;
• vagotomy;
• organ resection;
• pleural puncture.

In parallel with these actions, blood transfusion and the introduction of saline solutions are needed.

First aid for internal bleeding is vital, especially for parenchymal blood loss. Symptoms may be blurred at first, and symptoms appear when the life of the victim is in danger.

Internal bleeding is one of the most serious surgical and trauma problems. This is a hemorrhage, invisible from the outside. Only an experienced, qualified specialist can suspect the appearance of internal bleeding in time and provide assistance. In the article we will explain in detail why this pathology can occur and how to save a person's life.

Danger of internal bleeding

The insidiousness of the bleeding internal cavities in that the person himself does not notice it. Often the first manifestation is a loss of consciousness, when the amount of blood lost has already become too large. If a person has time to deliver to surgery and operate on the source of bleeding, then he will know about his illness after the operation.

Women are less sensitive than men to blood loss. This is due to physiological monthly bleeding during menstruation.

Therefore, men are more difficult to recover from blood loss, even if help was provided on time.

Symptoms

Signs of internal bleeding are divided into two groups:

• Symptoms of anemia - anemia;
• Symptoms of direct entry of blood into the cavity or tissue.

The cause of the first group of symptoms is the loss a large number erythrocytes and hemoglobin - anemia. Hemoglobin provides oxygen to every cell in the body. Therefore, hemorrhage is manifested by signs of anemia, which is called posthemorrhagic. This means that it arose against the background of blood loss.

Manifestations of anemia are nonspecific and are similar to a number of other diseases:

• Dizziness;
• severe weakness;
• Dry mouth and thirst;
• Nausea, vomiting;
• Shortness of breath, difficulty breathing;
• Frequent heartbeat;
• Low pressure;
• Paleness of the skin and mucous membranes.

internal bleeding

If the bleeding is very slight, drip, but continues for many years, then chronic iron deficiency anemia develops.

In this case, a person has:

• Perversion of taste or smell: desire to eat earth, chalk, etc., inhale gasoline vapors;
• Symptom of "blue sclera", when vessels appear through the shell of the eye;
• Dry skin;
• Brittle hair and nails.

The second extensive group of symptoms of internal bleeding is associated with the ingress of blood into the cavity, for example, the abdominal or chest. These manifestations are important to know how to determine the source of the hemorrhage.

Place of blood loss	Symptoms
intracranial	Loss of consciousness, convulsions, coma
Pulmonary	Cough with pink foam
into the pleural cavity	Difficulty breathing, heaviness in the chest
Into the abdominal cavity	Abdominal pain, additional objective symptoms
From the esophagus	Vomiting bright red, scarlet blood
From the stomach	Vomiting dark, almost black blood
From the small intestine	Black chair - melena
From the rectum	Red blood streaks in stool
intra-articular	Joint pain, swelling

Varieties

Types of internal bleeding are divided not only depending on the place of blood loss.

The classification necessarily includes a division according to the volume of blood lost:

• Lung– up to 500 ml;
• The average- 500-1000 ml;
• heavy- 1000-1500 ml;
• massive- more than 1500 ml.

These are average volumes calculated for a person weighing 70-80 kg. Naturally, for a teenager or a child, the numbers of blood loss will be much smaller. For them, the calculation is carried out based on the volume of circulating blood (BCC). This total blood in the body - 7% of body weight. A loss of up to 10% of BCC is considered mild, while a loss of more than 30% is considered severe and life-threatening.

There is a division of bleeding depending on the cause of rupture of the vessel:

• Mechanical- as a result of a blow, injury;
• Arrosive- due to damage to the vessel wall by a tumor or necrosis.

Causes

The source of internal bleeding can be any vessel damaged by injury, tumor or ulcer. One of the most common is gastrointestinal bleeding. Blood loss may be due to pathologically dilated veins in the esophagus, which quickly rupture. This condition occurs with cirrhosis of the liver.

Similar symptoms of blood loss from the vessels of the esophagus appear in Mallory-Weiss syndrome. This condition is associated with repeated, repetitive vomiting, such as with alcohol abuse. From frequent vomiting movements, ruptures of the esophageal mucosa appear.

Hemorrhage in the stomach occurs from an ulcer or tumor. If blood flows out of the ulcer in small portions, drip, then it comes out with feces, staining it black. If it bleeds from lower divisions intestines - large intestine or rectum, then in the stool you can see scarlet blood. The most common source in this case is hemorrhoids. Bleeding tumors and colon polyps are less common. Day after day, without noticing blood loss, a person can reach a severe degree of anemia - this is why such latent gastrointestinal bleeding is dangerous.

Bleeding in the abdominal cavity often occurs after abdominal trauma.. This may be damage to the parenchymal organ - the liver, spleen. Then the surgeon reveals specific features, for example, a symptom of a vanka-vstanka. It is characteristic of bleeding from the spleen when a sick person lies curled up on his left side.

When you try to change position - turn around, sit down - there is severe pain in the abdomen. It makes a person return to the previous position again, like a child's toy roly-poly.

In women, bleeding is often caused by apoplexy - rupture of the follicle in the ovary. There is pain in the lower abdomen, extending to the perineum and general symptoms of blood loss. Often there is an ectopic pregnancy, with a rupture of the tube and the appearance of intra-abdominal hemorrhage. With apoplexy, the ovary usually bleeds slightly, but with ectopic pregnancy bleeding is critical.

A rare type of internal bleeding is pulmonary. It arises from small vessels lungs, but there are episodes of severe blood loss from large vessel bronchi.

The reasons are:

• Tumors of the lung;
• Abscess;
• Tuberculosis.

The main and frightening symptom that the lung tissue is bleeding is frothy, pink sputum when coughing.. This sign allows you to recognize where the blood loss comes from: from the lungs or from the esophagus. Blood can also accumulate in the chest cavity, which occurs with injuries with rib fractures.

The most dangerous internal bleeding accompanies a traumatic brain injury. The skull protects the brain, and, at the same time, does not allow to accumulate in its cavity excess fluid. Even a small amount of blood compresses the tissue and causes severe symptoms. Hemorrhage into the ventricles of the brain can cause rapid death due to cerebral edema.

Slightly less dangerous is hemopericardium - the accumulation of blood around the heart due to a chest injury. With internal bleeding of a small volume, a person feels a strong heaviness in the chest and pain. With further accumulation of blood, the heart is compressed from all sides. Without timely treatment this can lead to cardiac arrest.

First aid

When the first signs of bleeding appear, it is important to quickly determine the source and provide first aid. For gastrointestinal bleeding, food or medicine should not be offered. Only a small amount of water is allowed. If bleeding is expected in the abdominal cavity, then an ice pack should be applied to the sore spot.

When symptoms of bleeding appear in chest cavity all squeezing clothes are unbuttoned - shirts, ties, belts. It is important to ensure calm breathing and move the victim as little as possible. Pulmonary bleeding needs similar care.

Regardless of the source of the suspected bleeding, qualified medical assistance should be provided as early as possible. With every minute, the hemorrhage will only increase. The more blood is lost, the less chance of a favorable outcome. The loss of half of the volume of circulating blood will be considered critical.

Treatment in a hospital

After the clinic determines the source of the hemorrhage, complex therapy. In case of injuries of the chest and abdominal cavities, the source of hemorrhage is eliminated with the help of an operation. With pulmonary bleeding or a small hemorrhage in the stomach or esophagus, help is provided with an endoscope. The volume of liquid is replenished with solutions, for example, Ringer, Reopoliglyukin, Hemodez.

After stopping the bleeding, it is imperative to restore the number of red blood cells. This will allow a person to get rid of the debilitating symptoms of anemia in the future. Depending on the degree of anemia, different drugs will be used.

Internal latent bleeding, i.e., bleeding into closed body cavities, occurs mainly as a result of damage to internal organs (liver, lung, etc.), and blood is not released to the outside.

There are specific symptoms of internal bleeding, the knowledge of which can help in the timely diagnosis of this complex problem.

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

Bleeding into the abdominal cavity is manifested by pallor, weak frequent pulse, thirst, drowsiness, darkening of the eyes, fainting. With bleeding into the 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, respiratory disorders, paralysis, etc.

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

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

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

The 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 be revealed only after some time:

• Blue skin (hematoma formation in the area of ​​injury)
• soft tissues painful, swollen, or hard to the touch
• Feelings of agitation or anxiety in the victim
• speeded up 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 body openings (nose, mouth, etc.)

First aid for internal bleeding:

• Provide complete peace
• Place the victim in a semi-sitting position
• Apply ice to suspected bleeding site cold water
• Urgently deliver the victim to the surgical hospital

Frequency of internal bleeding

Most often, bleeding occurs with damage to the organs of the gastrointestinal tract. Therefore, it is worth familiarizing yourself with the methods emergency care gastrointestinal bleeding. In total, about 20 diseases are distinguished, the most significant and common among which are: acute erosive gastritis and stomach cancer varicose veins veins of the esophagus, cirrhotic liver damage. In the case of stomach cancer, the danger is a decaying tumor. The only sign that allows the patient to suspect something is wrong is the darkening of the feces, which occurs due to the coagulated blood contained in it. If vomiting occurs, then the vomited masses, again due to clotted 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, stomach from bleeding with a damaged lung. When lung pathology frothy, unaltered blood of a scarlet color is released.

Diseases of the female reproductive system can also cause internal bleeding. Most common cause is a tubal abortion. At break 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. In the future, 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 thready. On examination, abdominal distention, stool and gas retention are detected. The patient becomes pale, covered with a cold sweat.

Symptoms of a hemothorax (blood in the chest)

How to identify and recognize internal bleeding in the chest? In case of accumulation of blood in pleural cavity the so-called hemothorax develops. 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, knife wounds, lung cancer, abscesses of the lung (that is, the formation of abscesses in the tissue of the lung).

With the accumulation of blood in the pleural cavity, there is difficulty breathing when inhaling and coughing, sharp pains in the chest, a violation of the general condition - dizziness, weakness, fainting, pallor of the skin, increased heart rate and respiration, sweating. Percussion of the patient's chest reveals shortening percussion sound over the affected half, weakening or complete absence breathing. On the radiograph, it is possible to determine signs of mediastinal displacement towards a healthy lung.

Hemarthrosis (blood in the joint cavity)

Frequent damage to the joints is the development of hemarthrosis, which means the accumulation of blood in the joint cavity. There is a similar condition as a result of trauma, less often with hemophilia, scurvy. The anemic symptom is expressed slightly in contrast to the local symptoms. The clinic distinguishes three degrees. With hemarthrosis of the 1st degree, there is 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. Grade 2 is characterized by a pronounced pain syndrome, which increases with stress, smoothness of the joint is noted. There is an increase in the circumference of the affected joint by 1.5 - 3 cm compared to the 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 3 degrees pain syndrome pronounced sharply, the outlines of the joint are completely changed. In circumference, the joint increases to 5 cm, mobility is sharply limited. Blood volume - more than 100 ml.

General symptoms

Thus, there are signs of bleeding that occur in any case, regardless of the source of bleeding. TO early signs include: pallor of the skin and visible mucous membranes, cold sweat, general weakness, dizziness, darkening in the eyes, with lung damage - a cough with streaks of blood, with the involvement of organs in the process digestive system- bloody vomiting or bloody diarrhea, symptoms of peritoneal irritation, which occurs when the 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 these 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 - the pulse is not more than 75 beats per minute, systolic pressure decreases to 100 mm Hg. Art.; with an 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

With a combined injury, laparocentesis is performed, it is a simple, fast, affordable and sparing method for diagnosing damage to the abdominal organs and internal bleeding. Also sometimes produce ultrasound of the abdominal cavity.

An important point in confirming the diagnosis is to conduct 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 faster the recovery process will be.

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

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