Abdominal bruise is a serious injury that occurs very often. On average, it accounts for up to 4% of the total number of bruises. At the same time, they are classified as one of the most severe, since the likelihood of death is high. Statistics of deaths from injury say that abdominal injuries occupy third position, second only to craniocerebral injuries in terms of the number of deaths. A bruise can be caused by a fall, an accident, natural disasters, or a fight.

Contusion of the anterior abdominal wall in accordance with the international classification of diseases ICD 10 suggests that the classifier code is S30.1. This is an injury to the abdominal wall. Section S30 includes the lumbar, pelvic, and lower back areas.

Causes

Bruises of the anterior abdominal wall in both children and adults are called abdominal by medical staff. They are distinguished by a large number of possible functional disorders and loss of anatomical integrity.

Most often, abdominal injuries in children and adults are closed-type injuries, accounting for about 85% of the total number. Open damage is only 15%, and their main causes include the following:

1. Falling from a height, including landing with the abdominal wall on sharp surfaces or elements.
2. Various wounds from firearms or cold steel (knife).

The consequences of such wounds can be different - bleeding, organ prolapse. If the latter is present, it is not allowed to reset the organs yourself, so as not to harm the victim.

There are many more causes of closed blunt abdominal injuries, the main ones include:

1. Exposure to iatrogenic factors, including therapeutic effects and risks.
2. Accidents that may occur in the workplace.
3. Falling on various objects - hard and blunt.
4. Blows.
5. Ingestion of aggressive chemicals, which include acids and alkalis, and objects with sharp corners.

Symptoms

The main characteristics of abdominal contusion include a large number of severe injuries, the need for postoperative intervention and the presence of subsequent complications, and a high mortality rate.

Signs of open and closed injuries are fundamentally different. These differences include:

1. Receipt mechanism.
2. The severity of the condition.
3. Methods for diagnosing damage and subsequent treatment.
4. The final outcome.

All this leads to the fact that symptoms of damage of different nature are considered separately. Symptoms may be as follows:

1. Injury to the abdominal wall. They are characterized by swelling and pain. The pain intensifies during sneezing and coughing, with a sudden change in body position and during bowel movements.
2. Ruptures of fascia and muscles. The symptoms are basically the same, but the abdominal pain is more pronounced.
3. Rupture of the small intestine. The main manifestations are vomiting, rapid pulse, and a feeling of muscle tension.
4. Colon rupture. The signs are similar to the injury described above, but the appearance of shock from pain is more common, and there may also be internal bleeding.
5. Closed abdominal injuries. A common consequence is internal bleeding, fainting, low blood pressure, pale skin, bladder rupture.
6. . These are primary and secondary injuries, the latter usually observed in children. There is severe pain and spontaneous bleeding. There are also symptoms of painful shock.
7. Pancreatic injuries. This could be a bruise, a concussion or a rupture.
8. . Pain in the lumbar region, blood in the urine, and increased body temperature are observed.

With any type of injury there are soft tissue bruises and bruises.

First aid

A bruise of the abdominal wall necessarily requires primary care. When providing first aid for abdominal bruises, do the following:

1. The patient should lie in a comfortable position.
2. You need to put something light and cold on your stomach.
3. If there are no visible signs of injury, the symptoms are clarified in order to give the person a painkiller. Injection of ketorolac or 50% metamizole solution is allowed. For open injuries, you can use narcotic painkillers, for example, trimeperidine.
4. After providing primary care, the patient is quickly taken to the nearest medical facility or an ambulance is called.

The specifics of first aid do not differ depending on how the injury was received, for example, in an accident or a fall from a height.

Diagnosis and treatment

A contusion of the anterior abdominal wall can have varying severity. The main difficulty is the absence of external wounds and bleeding. Internal blood loss is observed, which worsens the patient’s condition and complicates the initial diagnosis. In any case, in the presence of closed and open abdominal injuries, immediate surgical intervention is required.

Therapeutic methods of diagnosis and treatment are selected immediately after the initial diagnosis. They allow you to stop or prevent bleeding of internal organs and the possibility of peritonitis. Further treatment is often surgical.

Diagnostics assumes the following:

1. Blood and urine tests.
2. Electrocardiogram.
3. X-ray to determine the extent of damage.
4. Ultrasound examination to determine the presence of bleeding.
5. CT scan.
6. Catheterization technique if there is suspicion of bladder rupture.
7. Laparoscopy.

Treatment of open and closed abdominal trauma differs. Any open wounds necessarily require prompt surgical intervention. Penetrating wounds are treated depending on the organ injury. Non-penetrating injuries require surgery and irrigation of the area. After the operation, structures that are not viable are excised and sutures are applied.

Clinical surgery of other injuries involves the following:

1. Surgical treatment methods are in demand for fascia and muscle ruptures, bruises
2. Large hematomas are opened under local anesthesia. Finally, apply a sterile pressure bandage.
3. Organ injuries require rapid surgery and blood transfusions.
4. Patients are prescribed bed rest, physical therapy, and infusion therapy.
5. During the postoperative period, antibiotics and analgesics are prescribed.

Complications and consequences

Contusion of the anterior wall and stomach can have a number of complications:

1. Development of peritonitis.
2. Internal bleeding, which leads to a sharp deterioration of the condition. Possible death from massive blood loss.
3. Abdominal sepsis.
4. Septic shock.
5. Enteral failure.

Dear readers of the 1MedHelp website, if you still have questions on this topic, we will be happy to answer them. Leave your reviews, comments, share stories of how you experienced a similar trauma and successfully dealt with the consequences! Your life experience may be useful to other readers.

Closed (blunt) abdominal trauma is an injury that is not accompanied by a violation of the integrity of the abdominal wall. These injuries are also called "non-penetrating" injuries. However, the absence of visual pathologies is not evidence of the safety of internal organs. Closed abdominal injuries are accompanied by damage to the pancreas, spleen, liver, intestinal tract, bladder and kidneys, which affects the patient’s health and can be fatal.

Etiology

A blow to the stomach is considered the main cause of damage to internal organs. Most patients injured in this manner were relaxed at the time of injury. The muscles are at rest, which provokes the penetration of the impact force deep into the tissues. This damage mechanism is typical for the following cases:

• criminal incidents (punching or kicking in the stomach);
• falling from height;
• car crashes;
• sports injuries;
• an indomitable cough reflex, accompanied by a sharp contraction of the abdominal muscles;
• industrial disasters;
• natural or military disasters.

At the time of exposure to a destructive factor that causes bruises of the abdominal wall, the presence of obesity and, conversely, exhaustion or weakness of the muscular system increase the risk of damage to internal organs.

Frequent clinical cases are those connecting blunt injuries to the abdomen with fractures of the bones of the limbs, pelvis, ribs, spine, and traumatic brain injury. This mechanism causes the development of large blood loss, aggravates the patient’s condition and accelerates the onset of traumatic shock.

For any minor injury, you should go to the nearest emergency room. Working around the clock, employees will provide first aid, deciding on further hospitalization and the presence of internal injuries. Note! In case of a serious condition of the victim or if there is any suspicion of rupture of an internal organ, independent movement of the patient is contraindicated. You should definitely call an ambulance.

Classification

Blunt abdominal injuries are divided according to the following principles:

1. Without any damage to the abdominal organs (bruises, ruptures of muscle groups and fascia).
2. With the presence of damage to internal organs located in the peritoneal space of the spleen, parts of the intestinal tract, bladder).
3. With damage to retroperitoneal organs (rupture of the pancreas, kidney).
4. Pathology with intra-abdominal bleeding.
5. Damage accompanied by the threat of peritonitis (trauma to hollow organs).
6. Combined damage to parenchymal and hollow organs.

Pain syndrome

Closed abdominal injuries are characterized by the first and main complaint from the victim - the appearance of painful sensations in the abdomen. It is important to remember that the erectile phase of shock may be accompanied by suppression of pain, which complicates the diagnosis of pathology. In the case of combined injuries, pain from fractures of the ribs or bones of the limbs or pelvis can push the symptoms caused by blunt trauma to the abdomen into the background.

The torpid stage of shock suppresses the intensity of painful conditions due to the fact that the patient is disoriented or unconscious.

The nature of the pain syndrome, its intensity and irradiation of sensations depend on the location of the damage and the organ involved in the process. For example, a liver injury is accompanied by a dull aching pain radiating to the area of ​​the right forearm. A splenic rupture manifests itself as pain radiating to the left forearm. Damage to the pancreas is characterized by girdling pain in the area of ​​both collarbones, lower back, and left shoulder.

Splenic rupture, the consequences of which are severe for the patient due to excessive blood loss, accompanies a third of all closed abdominal injuries. Damage to the spleen and left kidney occurs frequently. Often, a doctor has to re-operate on a patient if he has not seen the clinical picture of one of several injured organs.

Traumatization of the upper part of the intestinal tract, accompanied by rupture of the walls, is manifested by a sharp dagger pain that appears due to the penetration of intestinal contents into the abdominal cavity. Patients may lose consciousness due to the intensity of the pain syndrome. Damage to the colon is less aggressive in its manifestations, since the contents do not have a strong acidic environment.

Other clinical signs

Blunt abdominal trauma is manifested by reflex vomiting. In cases of rupture of the walls of the small intestine or stomach, the vomit will contain blood clots or be the color of coffee grounds. Such discharge with feces indicates trauma to the colon. Injuries to the rectum are accompanied by the appearance of scarlet blood or blood clots.

Intra-abdominal bleeding is accompanied by the following symptoms:

• weakness and drowsiness;
• dizziness;
• the appearance of “flies” before the eyes;
• the skin and mucous membranes acquire a bluish tint;
• reduced blood pressure;
• weak and rapid pulse;
• frequent shallow breathing;
• the appearance of cold sweat.

Damage to hollow organs causes the development of peritonitis. The victim’s body responds to such a pathology by raising body temperature (in case of severe blood loss - hypothermia), uncontrollable vomiting, and stopping the peristalsis of the intestinal tract. The nature of the pain is constantly changing, alternating between severe pain and its temporary disappearance.

Traumatization of the urinary system is accompanied by the absence or disturbance of urine output, gross hematuria, and painful sensations in the lumbar region. Later, swelling develops in the perineal area.

Damage without traumatizing internal organs

Contusion of the anterior abdominal wall is manifested by local visual changes:

• swelling;
• hyperemia;
• soreness;
• presence of bruises and abrasions;
• hematomas.

The pain that accompanies a bruise intensifies with any change in body position, sneezing, coughing, or defecation.

Blunt abdominal trauma may be accompanied by fascial tears. The patient complains of severe pain and a feeling of bloating. Dynamic paresis of the intestinal tract appears, and, accordingly, the dynamic nature of the obstruction. Rupture of muscle groups is accompanied by local manifestations in the form of pinpoint hemorrhages or large hematomas, which can be localized not only at the site of injury, but also far beyond its borders.

The final diagnosis of “damage to the anterior abdominal wall” is made if the absence of internal pathologies is confirmed.

Diagnostic measures

Differential diagnosis of the patient’s condition begins with collecting anamnesis and trauma genesis. Further, determining the victim’s condition includes the following examination methods:

1. A general analysis of peripheral blood shows all the signs of acute blood loss: a decrease in red blood cells and hemoglobin, hematocrit, leukocytosis in the presence of the development of an inflammatory process.
2. A general urine test determines gross hematuria, and if the pancreas is damaged, the presence of amylase in the urine.
3. Instrumental examination methods include bladder catheterization and insertion of a probe into the stomach.
4. Ultrasound examination.
5. with intravenous administration of contrast agent.
6. Radiography.
7. Other examinations if necessary (cystography, rheovasography, ERCP).

Differentiation of pathology

The study of the organs located there should be multifaceted, since combined injuries can suppress the symptoms of one injury, bringing to the fore the clinical picture of the injury of another.

Differential diagnosis of abdominal injury

Organ	Clinical signs	Differential tests
Anterior abdominal wall	Soreness and muscle tension upon palpation; when determining a space-occupying lesion, the presence of a hematoma should be checked.	You can distinguish a hematoma from a neoplasm using a test: the patient lies on his back and strains his muscles. The hematoma will be felt in both a tense and relaxed state.
Liver	Pain in the projection of the organ, often simultaneously with fractures of the lower ribs on the same side. Increased abdominal volume, hypovolemia.	CT: organ rupture with bleeding. CBC determines anemia, low hematocrit. Ultrasound - intra-abdominal hematoma. Retrograde cholangiography indicates damage to the biliary tract. DPL - blood available.
Spleen	Pain in projection, combined with rib fractures. The pain radiates to the left shoulder.	CT: splenic rupture, active bleeding. UAC - decrease in hematocrit and hemoglobin. DPL detects blood. Ultrasound shows an intra-abdominal or intracapsular hematoma.
Kidneys	Pain in the side and lower back, blood in the urine, fractures of the lower ribs.	GAM - gross hematuria. CT scan of the pelvis: slow filling with contrast agent, hematoma, possible hemorrhage of internal organs located near the site of injury.
Pancreas	Abdominal pain radiating to the back. Later, muscle tension and symptoms of peritonitis appear.	CT: inflammatory changes around the gland. Increased amylase and lipase activity in blood serum.
Stomach	Daggering pain in the abdomen due to the release of acidic organ contents into the abdominal cavity	X-ray: free gas located under the diaphragm. The injection determines the presence of blood.
Small part of the intestinal tract	Board-shaped abdomen, accompanied by a painful diffuse syndrome.	X-ray: presence of free gas under the diaphragm. DPL - positive tests for indicators such as hemoperitoneum, the presence of bacteria, bile or food. CT: presence of free fluid.
Colon	Pain with a tense abdomen, presence of blood on rectal examination. In the early period, without clinical signs of peritonitis, then a board-shaped abdomen with diffuse soreness.	The x-ray shows free gas under the diaphragm. CT: free gas or mesenteric hematoma, release of contrast into the abdominal cavity.
Bladder	Difficulty urinating and blood in the urine, pain in the lower abdomen.	CT scan detects free fluid. In the UAC, increased urea and creatinine levels. Cystography: contrast goes beyond the organ.

The emergency room, while providing medical care around the clock, is not able to carry out all of the above diagnostic methods, therefore, after the initial examination, the victim is sent to the inpatient surgical department.

First aid for abdominal injury

If damage to internal organs is suspected, the following rules should be followed:

1. The patient is placed on a hard surface and ensured a state of rest.
2. Apply cold to the injury site.
3. Do not give the victim water or food.
4. Do not take medications until the ambulance arrives, especially analgesics.
5. If possible, provide transportation to a medical facility.
6. If there is vomiting, turn the patient's head to the side to prevent aspiration of the vomit.

Principles of medical care

Blunt abdominal trauma requires immediate intervention by specialists, since a favorable result is possible only with timely diagnosis and initiation of treatment. After stabilizing the victim’s condition and carrying out anti-shock measures, patients are indicated for surgical intervention. Closed injuries require the following conditions to be met during operations:

• general anesthesia with adequate muscle relaxation;
• allowing access to all areas of the abdominal cavity;
• simple in technique, but reliable in outcome;
• the intervention is short in duration;
• Use the uninfected blood that has poured into the abdominal cavity for reinfusion.

If the liver is damaged, it is necessary to stop the bleeding, excision of non-viable tissue, and suturing. A rupture of the spleen, the consequences of which can lead to the removal of the organ, requires a thorough revision. In case of minor injury, stopping the bleeding with suturing is indicated. If the organ is severely damaged, splenectomy is used.

The tract is accompanied by the removal of non-viable tissue, stopping bleeding, revision of all loops, and, if necessary, intestinal resection.

Damage to the kidneys requires organ-preserving interventions, but in case of severe crushing or separation of the organ from the supplying vessels, nephrectomy is performed.

Conclusion

The prognosis of trauma to the abdominal organs depends on the speed of seeking help, the mechanism of injury, correct differential diagnosis, and the professionalism of the medical staff of the medical institution providing assistance to the victim.

Internal damage to tissues or organs is considered when the skin, bones and mucous membranes are not affected.

Bruises occur as a result of various mechanical damage, impacts, or falling on hard surfaces.

With a mild bruise, pain is felt in the muscles; with stronger blows, soft tissue ruptures and internal bruising appears. Depending on the severity of the injury, it may be a small bruise or hematoma after the swelling goes down. Mild bruises can be treated at home, but persistent pain should see a doctor.

Also, the severity of the consequences of a bruise is determined by the location of the injury and the volume of the affected area. A bruised finger against a wall with a blue nail is nothing compared to a head bruise of the same severity. Any bruise can be cured if you immediately contact a traumatologist.

Types of bruises and their symptoms

or shell shock are divided into types depending on the location and degree of damage to the body area. They can appear anywhere, from the eye to the foot, due to various random circumstances or simple carelessness.

Emergencies, accidents or production problems can also lead to bruises. It is an inevitable fact that you will get bruises and other types of injuries while playing sports, especially martial arts.

Medical practice, depending on the location of the bruise, distinguishes the following main categories:

Head contusion
One of the most serious types of injuries, which is often accompanied by a concussion. If the blow was strong enough, the pain envelops the head. You feel dizzy, weak, and slightly nauseous. Immediately after the blow, you should apply cold to the place where it hurts and lie down on a flat surface. If the pain does not go away after a couple of hours, you need to call an ambulance.

Brain contusion- this is one of the types of traumatic brain injury along with concussion and compression of the brain according to the classification of the French surgeon J.L. Petit. It is quite difficult to determine each type by external signs, so hardware diagnostics are required. Brain contusions are divided into 4 main groups:

shake– disturbance at the cortical level with clear consciousness;
mild bruise– functional changes in the central nervous system in the form of damage to the vessels of the arachnoid membrane;
moderate bruise– focal brain damage accompanied by paresis of the cranial abducens and oculomotor nerves;
severe bruise– damage to the brain stem, coma.

Immediately after the injury, it is necessary to place the wounded person on an elevated surface, apply a tight bandage, and call an ambulance.

Facial bruise
The face is the most visible part of our body; it cannot be hidden under clothing, so any bruises due to the slightest bruises and mechanical damage are immediately visible to others. As a rule, bruises on the face, nose, forehead or chin instantly turn blue. The first thing you need to do is apply cold compresses to relieve swelling. Associated abrasions should be treated with iodine, brilliant green or hydrogen peroxide to avoid tissue infection. When the nose is bruised, it is very painful, swollen and deformed. In case of facial injuries, you should consult a doctor and stay in the hospital.

Bruised eye
Our eyes are very sensitive, and any mechanical impact, especially strong, immediately causes bruising and filling of the white with blood, resulting in bruising. When the eye is swollen, its function is impaired as it becomes completely swollen. Depending on the force of the blow, pain may not be felt in the very first hours. First aid for an eye injury should be provided by an ophthalmologist, since independent actions can lead to visual impairment.

Bruised tooth
A closed wound of a specific tooth due to mechanical action without much disruption of tissue integrity. As a result of the tear, the tissues that hold the tooth in the alveolus and pulp tissue are damaged.

These damages are most often reversible with timely visit to the dentist. A tooth bruise is characterized by pain when eating, darkening of the tooth, and swelling of the gum mucosa. The first measures for a tooth bruise are applying ice and avoiding hard foods.

Chest contusion
Most often, this kind of bruises occur during accidents or other disasters and are accompanied by rib fractures and damage to lung tissue. Symptoms of a bruise include severe pain, bruising and shortness of breath. The first aid in such a situation will be to place the victim in an elevated, reclining position and fix the chest with a tight, airtight bandage.

Back bruise
Due to the fact that the sensitive spinal cord is located in the center of the spine, a back injury can have quite serious consequences. When a spinal bruise occurs, focal hemorrhages and disturbances in the circulation of cerebrospinal fluid are observed.

When a spinal bruise occurs, swelling occurs and a hematoma forms, all of which is accompanied by pain and difficulty defecating due to spinal shock. Additional signs may include loss of sensation in the affected area and paralysis. Treatment of a back injury is carried out in a hospital.

Bruised leg
Severe leg bruises are characterized by swelling and pain in the foot, and a lump forms. In cases where the blow was struck obliquely, skin detachments may appear, which worsens the condition of the hematoma and can develop into a traumatic cyst. There is also a risk of blood getting into the muscle tissue of the leg.

Without immediate medical attention, this condition can result in tissue necrosis. The most severe pain syndrome is observed with a bruise in the lower leg area. A bruise can provoke limb dislocations, muscle strains or fractures.

Bruised hand and fingers
Hands are most often exposed to various injuries and bruises in everyday life. It is not difficult to identify a bruise; pain occurs in a specific location, the bruised area swells and a hematoma occurs due to bleeding into the soft tissue. After applying ice, it is worth treating open wounds, if any. If the pain does not go away, you should take general painkillers. If a fingernail is damaged, it is necessary to apply a tight bandage to the bruised area to fix it.

Bruised joints
When you fall or hit your elbow or knee with a hard object, acute pain occurs and the motor functions of the joints are difficult. Due to the fact that blood enters the joint, hemarthrosis occurs, sometimes of significant size. To diagnose joint damage, radiography in two projections is prescribed. Treatment of joint bruises is carried out in a hospital setting, but in the first hours after the injury you can take painkillers.

Internal organ bruise
The most complex type of bruise, which may not externally manifest itself in any way, except for symptoms of weakness and pain in a specific location, such as the kidneys, heart, spleen. At the first information about a bruise, it is important to take the victim to a hospital for diagnosis and treatment.

Bruise of the genital organs in men
As a result of the bruise, both the scrotum, testicles, and penis can be damaged. In addition to pain and redness, bleeding during urination and the formation of hematomas, as well as testicular dislocation, are noted. The injury can be either isolated, when only one organ is affected, or combined, if the injury affects all organs at once. After a comprehensive diagnosis, bed rest, wearing tight swimming trunks and antibiotics are prescribed.

According to the force of impact and the degree of damage to tissues and organs, bruises are divided into four degrees:

1. Characterized by the appearance of swelling and streaky and precise hemorrhages at the site of impact within the first hour;
2. The integrity of large vessels is disrupted, bruises and hematomas are formed. Such bruises are accompanied by acute pain at the site of injury;
3. There is rupture of blood vessels, muscles, nerve tissue and tendons, as well as cracks and internal fractures of bones or dislocation of joints. Tissue nutrition is disrupted and necrosis may occur if measures are not taken. Such severe bruises are typical for the joints, tailbone, knees and head;
4. Fracture of bones and tissues, characterized by an unfavorable prognosis.

Most bruises, with timely assistance, are completely curable in less than a month, unless they are complicated by other serious lesions and injuries.

Signs of bruise

Signs of bruises include severe pain at the site of injury, severe swelling and a bluish tint to the skin. Over time, the damaged area may change color to greenish-yellowish or distinct dark red, depending on the force of the blow. A head injury is characterized by general weakness, dizziness, nausea and even fainting.

With bruises of the limbs or tailbone, acute shooting pain intensifies when walking and other body movements, calming down in a horizontal position. A common symptom is hemorrhage into the joint and the formation of hemarthrosis. In addition, with severe bruises, the functions of the limbs are impaired, coordination is lost, tremors and uncontrolled muscle contractions appear. When the hematoma resolves, the symptoms disappear. With nerve contusions, paresthesia, paresis, and paralysis become common occurrences.

The appearance of hematomas and persistent pain for several hours are serious reasons to contact a traumatologist.

First aid for bruises

For bruises of any type and location, the first step is to apply ice to narrow the vessels damaged by the blow and relieve pain. It is applied through thick fabric to avoid hypothermia in several approaches of 10–15 minutes. If the bruise is accompanied by other skin lesions, they should be treated immediately, but do not use iodine; alcohol solutions and hydrogen peroxide are suitable. After the appearance of a hematoma, warming measures are prescribed, such as warm compresses, this helps relieve swelling and reduce pain.

For brain contusions, an aseptic bandage is applied to the head. To prevent aspiration of blood and vomit, the upper respiratory tract is cleaned. In case of unconsciousness, patients are carried out on a stretcher in a position on their side or stomach

Possible consequences after bruises

The bruise itself is not as bad as its possible complications. The consequence of a bruise can be fractures and hemorrhages. With an oblique blow, detachment of the subcutaneous tissue and the formation of large hematomas can occur, which can eventually turn into blood-filled traumatic cysts. When the hematoma suppurates, the body temperature can rise to 39 °C.

In bruised areas where large blood vessels pass, tears in the walls and the formation of blood clots and tissue necrosis can occur.

A meteorite falling on a person was recorded only once, but it was not a bruise.
The pain threshold in the same parrots is much higher than in humans, so even with obvious signs of a bruise or fracture, the bird can behave actively and mobile.

In places where peripheral nerves (elbow, radial joints) may be bruised, symptoms of loss of their function may appear. As a rule, motor and sensory disturbances pass very quickly, but sometimes there are cases when, with intrastem hemorrhages, traumatic symptoms persist for quite a long time.

Diagnostic methods

After a fall or impact with a blunt object, almost anyone can diagnose a contusion and the appearance of bruises; here you don’t even need to have a medical education. The task of doctors is to determine the strength of this bruise and the degree of tissue damage, whether there are fractures or not, whether internal organs are compressed. Already in the first hours after a bruise, you should consult a traumatologist, especially if the pain is severe and does not go away.

The main tools of traumatologists are hands and x-ray examination for the integrity of the skeleton. If the injury has affected the brain, x-rays may not be enough and magnetic resonance imaging (MRI) or computed tomography (CT) is prescribed.

In case of a chest contusion, which may be accompanied by a contusion of the heart or lungs, an electrocardiogram (ECG) becomes a mandatory method of investigation.

Also, to assess changes in the organs and systems of the body due to injury, it is sometimes necessary to take blood and urine tests, which is especially important for injuries to the head and genitals.

Only after diagnostic procedures have been carried out in a trauma center or in the department of traumatology and orthopedics can treatment be prescribed, otherwise, out of ignorance, you can only cause harm and remain disabled.

How to treat a bruise?

Treatment of bruises also depends on the location and extent of damage to the body area. The easiest way for bruises to arise and disappear is in the thigh area, where there is a lot of soft tissue; the consequences of bruises of the joints, especially the shoulder and internal organs, are more difficult and difficult to treat.

The main thing is that treatment of bruised tissues should begin immediately. The first remedy after an injury is applying cold to the injury site to reduce swelling and relieve pain. If the limbs are bruised, a pressure bandage is applied to them.

After the appearance of a hematoma, a bruise can be treated using various methods, both medicinal and physiotherapeutic. In most cases, doctors prescribe heat in the form of applying compresses, applying warming ointments and applying anesthetic cream. After a hematoma appears, a plaster splint may be applied to the knee, elbow or foot.

Bruises on the body are treated using thermal and physical warming effects. Manual massage is highly effective for resolving hematomas. Physiotherapeutic treatment, especially magnetic therapy and laser therapy, relieve inflammation in 4–10 procedures.

For bruised limbs, traumatologists recommend physical therapy courses to restore function. For bruises of the head and brain, rest and medications are predominantly prescribed.

In case of muscle bruises, when hemorrhages appear from ruptures and fibrous degeneration of muscle tissue occurs, punctures are performed surgically.

The main thing is to consult a doctor in a timely manner in order to make a correct diagnosis, then the treatment will be as effective as possible.

Traditional methods

In case of bruises, the first thing they resort to is traditional methods, since they are designed to relieve pain and speed up the process of restoration of damaged tissues. Various compresses and lotions are used to draw out hematomas:

A cold compress of vegetable oil, water and vinegar is applied to the bruise for several hours and tied to fix it.
- For severe bruises and suppuration, in the old days a special ointment was used, which was prepared in an oven and consisted of spruce resin, birch tar and lard. All components were placed in a clay pot and mixed. The resulting mixture was heated in an oven, and after cooling, it was applied to the sore spot using a cloth.
- The most famous remedy for wounds and bruises is burdock. On its basis, special oils are prepared for the treatment of bruises. To do this you need 200 grams of olive oil and 75 grams of burdock root. Mix all ingredients and put on fire, without bringing to a boil. The resulting medicinal oil should be rubbed on bruised areas to relieve pain.
- The juice of wormwood and thistle has pulling properties.
- Lotions made from oak bark and daisy flowers effectively relieve swelling.
- Compresses made from onions, crushed plantain leaves and honey will help quickly get rid of bruises.
- An infusion of 2 heads of garlic in 6% vinegar helps with swelling and pain; such a compress can be applied even if the eye is bruised.

For mild bruises and moderate injuries, the folk remedy is completely justified and gives effective results, but in severe cases, specialized medical care cannot be avoided.

Prevention of bruises

Unfortunately, no one is immune from accidental injuries, street fights and falls, so you can get hurt at any time. But it is quite possible to avoid serious consequences and complications.

First, you need to eat right to strengthen your bones. Your daily diet should include fresh vegetables and dairy products high in calcium. Regular exercise will also help strengthen your muscles and protect your body from serious damage in the event of an impact or unfortunate fall.

All this will make the skin more elastic, improve blood circulation, that is, bruises will heal faster and strengthen the bones, it will be possible to avoid fractures and cracks due to bruises.

A child can get injured in the chest and abdomen (abdominal organs) when falling from a height, from a bicycle, or in a traffic accident.

Another common cause of such injuries is fights among teenagers. Modern teenagers, brought up on the examples of “cool” movie heroes, flock in flocks and form an aggressive crowd that knows no pity or leniency, capable of beating and mutilating its victim for no reason. As a result of bloody showdowns, children with severe injuries are admitted to trauma departments, often leading to disability and a tragic outcome.

You need to be able to provide first aid and emergency care to a child in a timely and correct manner.

Chest contusions occur most often: while running, the child ran into a door frame, hit his side on the corner of a table or desk, falling from a bicycle, touched the steering wheel with his chest, etc. Pain appears at the site of the injury, sometimes swelling and hemorrhage. The pain intensifies with a deep breath, coughing and palpating the bruised area. For several days the child will spare the injured half of the chest, wince with awkward movements, but gradually the pain will subside, and after 7-10 days there will be no trace of the injury.

Chest contusions do not require any special treatment.

For severe pain, you can give an anesthetic tablet (analgin, aspirin, ortofen, nurofen, efferalgan) and rub ointment into the bruise site (finalgon, indomethacin, dollit-cream).

Clavicle fracture

Clavicle fracture in children it is one of the most common injuries, accounting for 13% of limb fractures and second in frequency only to fractures of the forearm bones. The mechanism of injury can be different, but most often a fracture occurs when falling on the shoulder or outstretched arm. Depending on the degree of displacement, complete or incomplete (subperiosteal) fractures are distinguished. The latter form is more common in newborns and small children, so it is easily visible.

30% of clavicle fractures occur between the ages of 2 and 4 years.

Deformation and displacement for incomplete fractures the clavicles are absent or minimally expressed. The function of the arm is preserved, only its abduction above the level of the shoulder girdle is limited. The pain is not pronounced, so such fractures are often not detected and the diagnosis is made after 10-15 days, when callus is detected in the form of a significant thickening on the collarbone.

For complete fractures the fragments are displaced, so recognizing a fracture is not difficult.

Treatment consists of matching the fragments and fixing them in the correct position. For young children, a Deso bandage is applied, bandaging the arm to the body for 7-10 days. In older children, a stronger fixation is required with the shoulder pulled back and the external fragment of the clavicle raised. Healing of clavicle fragments in older children occurs within 2-3 weeks.

Fractures of the sternum and ribs

Fractures of the sternum and ribs in childhood they are rare due to the elasticity and good shock absorption of the rib frame in case of injury, and occur under the influence of strong blows or falls on hard objects. There is a sharp pain that intensifies with movement, deep inspiration, and palpation of the affected area. Breathing becomes shallow and rapid. The patient takes a forced position, maximally easing his condition, and tries not to move. In this position you will take him to the traumatologist.

Dangerous complication of rib fracture is damage to the pleura and lung tissue by sharp bone fragments and the development pneumo- or hemothorax(entry of air or blood into the pleural cavity). It is important to recognize this serious and life-threatening complication in the first minutes, since the deterioration of the condition develops very quickly. Air and blood, accumulating in the pleural cavity, push the lung upward, turning it off from the breathing process. Sometimes air from the pleural cavity gets under the skin, swelling of the neck and chest occurs, and when the skin is palpated, a sound similar to the creaking of snow occurs. This sign reliably indicates that there is air under the skin. An intact lung works for two, breathing becomes frequent and shallow, the patient feels difficulty breathing, lack of air, becomes pale, covered in cold sticky sweat, lips and fingertips turn blue, which indicates respiratory failure. The heart rate increases, and for some time maintains blood pressure, but soon it drops, and then development is possible.

The victim requires immediate surgery; without it, he will die in a matter of hours.

Penetrating chest wounds

For penetrating chest injuries affecting the lung tissue, air enters the pleural cavity and under the skin not only from the respiratory tract, but also from the environment as a result of the suction action of the chest. Each breathing movement is accompanied by extraneous sounds that arise at the site of injury. And with every breath the patient’s condition worsens. Before transporting the patient to the hospital, it is necessary to cover the wound with an airtight bandage (cellophane, oilcloth) to prevent air absorption.

If the object used to inflict it (knife, screwdriver, scissors) is sticking out of the wound, do not remove it.

As long as it occludes the wound, the risk of pneumothorax and bleeding is low. The victim is hospitalized in a semi-sitting or sitting position, so it is easier for him to breathe.

Blunt abdominal trauma

Blunt abdominal trauma may be limited to a bruise of the abdominal wall, and with a strong blow, internal organs (liver, spleen, intestines) may be damaged until they rupture, accompanied by internal bleeding.

Damage to internal organs is more common in boys, which is a result of their increased activity. The degree of damage to organs depends on their condition at the time of injury. Thus, a blow to the stomach after a heavy meal is more likely to lead to rupture of a hollow organ than a blow of the same force, but delivered on an empty stomach. If the abdominal press is well developed, then at the moment of impact, muscle tension will protect the internal organs from external influences.

Possibility of internal bleeding

Internal bleeding does not always appear immediately. Sometimes, after an injury, a child gets to his feet and has no complaints, and palpation of the abdomen does not reveal any tension in the abdominal wall or pain. However, the child should be monitored because symptoms of internal bleeding worsen over several hours. Weakness, lethargy, pallor, and sometimes nausea and vomiting appear. When a hollow organ ruptures, the child complains of severe pain throughout the abdomen, and repeated vomiting occurs almost constantly. The clinical picture corresponds to peritonitis.

Ruptures of the liver or spleen

If it happened rupture of the liver or spleen, then the pain is not severe, and vomiting appears on the second or third day after the injury. Even more insidious are subcapsular ruptures of the liver and spleen. There was a rupture of the organ and bleeding from it, but the capsule was not damaged, so the blood accumulates under it, and there are no signs of internal bleeding. The child continues to lead an active lifestyle, and suddenly, after a few days, unexpectedly, after a sudden movement, the capsule ruptures and blood pours into the abdominal cavity. Therefore, in case of closed abdominal injuries, consultation with a surgeon is necessary, and in some cases, dynamic monitoring of the child in a hospital setting.

Penetrating abdominal trauma

Penetrating abdominal wounds are always a reason for hospitalization in the surgical department. We have already spoken more than once about the need to leave a foreign object in the wound that caused the injury. So, in a state of panic, do not pull the knife out of the wound. Apply a pressure bandage and take the child to the hospital. During transportation, the victim should lie with his legs elevated.

Video on the topic

Trauma to the neck, back, chest, abdomen, perineum: emergency care - Dr. Komarovsky

Did you fall unsuccessfully yourself or did someone hit you? How to determine whether you need to see a doctor and what you can do to help immediately after an injury? Dr. Komarovsky will talk about the rules of first aid for various injuries and signs indicating internal bleeding and rupture of the spinal cord, and also remind you what not to do for penetrating wounds.

Our children are restless and daredevil; as soon as they start moving, they strive to crawl to the edge of the sofa, changing table or crib. There is not a single child who has not fallen at least once in his life, falls are just different - dangerous and not very dangerous, with and without injuries. It is important for parents to know where and how a crumb can fall and be able to assess the child’s condition, provide an adequate amount of assistance and know. where and in what cases you need to contact.

How do they fall?

For some reason, parents believe that since the child does not walk or crawl, it means he cannot fall, and they carelessly leave him on the changing table, sofa or edge of the bed. Remember, dear fathers and mothers. A baby can fall even at one month of age; due to the chaotic movement of arms and legs, he can push off from the support and slide down the diaper or oilcloth. Never leave your child alone even for a second from birth, develop a conditioned reflex - never leave your child lying on a high surface!
The statistics of falls of children in the first years of life are varied - they fall from strollers and cradles, from changing tables, beds, sofas, walkers, jumpers and high chairs. Sometimes parents don’t think that the baby might fall, and they simply don’t have time to react and catch the child.
Any serious injuries to a young child, to our great regret, are associated with our parental carelessness and oversight. It is always worth remembering that at three months the baby can roll over on its side, at 6-7 months it can crawl, and at 7-9 months it can stand up and hang over the edge of the sofa or bed. The fall of a baby is unpredictable - therefore, it is necessary to closely monitor the babies and prevent accidents.

Falls at home and on the street.

In the house, the leaders in the number of falls are high chairs, when the mother sat the baby down and turned away to prepare him puree or porridge. The baby is bored, he easily twists out even from fastened belts and tries to get out of the chair.
In second place are changing tables, even if they have sides. Kids are quite active and the side is not a serious obstacle for them. The tables are usually quite high, so these falls are very serious.
The third place is for strollers, mostly these are seated strollers or transformers; the baby already knows how to sit in them, but not yet how to get out of them correctly. If mom is a little distracted and the baby is not fastened with seat belts, he may fall.
Children often fall from their parents' bed or sofa when their parents leave the room or turn away for just a moment. The baby could crawl or simply move actively and thus move to the edge and fall from there. In the first 2-3 months, many parents recklessly leave their babies like this, hoping that they will not go anywhere.
Newfangled jumpers and walkers are especially dangerous in terms of injuries; they cause some of the most severe injuries in children. Children of the first year, due to the underdevelopment of the cerebellar centers, do not yet know how to maintain balance; in the process of learning to walk, they learn to coordinate their body correctly. And these devices give a distorted picture of space and a sense of stability. Children hang over the edges of their walkers, trying to get out, get caught in the wheels on uneven floors, and fall down stairs in their walkers. When jumping, children hit their heads on door jambs, fall out of fastenings, or fall when fastenings break or burst (especially for cheap or low-quality products).
On the street, the leaders of falls are stairs where a mother or father was walking with a baby in their arms; hiking in icy conditions, entering and exiting public transport, and also the state of intoxication of parents are especially dangerous.

Features of injuries in children at different ages.

Infants most often suffer traumatic brain injuries from falls. This is due to the fact that their head is much heavier than the rest of the body; when falling, it outweighs and children fall, first of all, hitting their heads. Of course, the baby’s skull has fontanelles and open seams, and up to a certain point it softens the blows, protecting the brain, however, it is not worth testing the child’s strength.
Older children usually, due to the changing proportionality of the body, receive injuries of a different kind - in addition to head injuries, they add injuries to the limbs, wounds, cuts, fractures, and bleeding.
Until about 3-4 months, the baby is relatively calm and his motor activity is not so pronounced. However, this is not a reason to relax - it also requires constant supervision. But by 3-5 months, when most babies already know how to roll over from side to side, they become very active and fast. Leaving them on the sofa or bed unattended is simply unacceptable. For such a baby, falling from a height of even 40-50 cm is dangerous, especially if he hits his head. This can lead to a concussion, brain contusion and cracked skull bones, all depending on the surface on which it falls. Damage to internal organs and bones is extremely rare.
One-year-old babies begin to walk, which leads to falls from their own height. The task of parents with the baby’s first steps will be to protect him from injury, but in no case limit his freedom and movements. It is necessary to show the child where danger may be and teach him how to properly get off the sofa, chair or stroller. At first, protect your baby from obstacles in his path, close the corners and remove all obstacles from under his feet. The most dangerous falls for children of this age are from a height of 80-100 cm, that is, the height of their height.
In children aged 2-3 years, who can actively run, jump and gallop, the nature of injuries changes. They usually fall from slides, swings and other structures in playgrounds. Usually this is a height of 1-3 meters, which is very dangerous in terms of fractures, injuries to the head, back and abdomen. Therefore, parents’ vigilance should be doubled; teach your child to go up and down stairs. Climb structures correctly and teach them how to jump correctly.

What if he did fall?

Sometimes, despite all our precautions, children fall, what should parents do? The most important thing is not to panic; most falls, other than a small bump, loud crying and frightening of the child, do not cause any consequences. If you think that the child’s injury is serious, you should not throw hysterics, you need to pull yourself together in order to provide timely and correct assistance to the child.
It must be remembered that symptoms of mild injuries appear within 1-2 hours, severe injuries may have a delayed period of manifestation. It is necessary to remember that you need to carefully monitor the child’s condition during critical hours - the first and third hours, and then 12 and 24 hours after the injury. If the child is over 2 years old, at night after an injury, wake him up every 2-3 hours and ask simple questions. This will help to adequately assess the child’s state of consciousness.
In the first minutes after a fall, you need to put aside thoughts that the child is mortally injured or, conversely, that this is a nonsense fall. Assess the child’s condition soberly and objectively. First of all, we pay attention to whether there is swelling in the soft tissues (bump), whether there is a hematoma (accumulation of blood under the skin), abrasions, cuts or bleeding. You can apply cold to the site of the injury (a rag soaked in cold water or ice in a towel). If there is blood coming from the wound, apply a piece of clean, dry cloth or bandage to it and apply pressure. If the wound bleeds, the tissue becomes saturated with blood, or the bleeding does not stop for 10-15 minutes, call a doctor or take the child to the emergency room.
Calm the crying baby and carefully evaluate how the child behaves, is he inhibited or excited, is he adequate, does he answer questions?

Urgent ambulance!

There is a set of very alarming symptoms that indicate the possibility of serious injury and require an immediate call for an ambulance and referral to a hospital. First of all, you need to look the child in the eyes, assess the condition of the pupils; if they are of different sizes, sharply dilated or narrowed - this is very dangerous. It is necessary to measure the child's pulse - for children under one year old it should be at least 110-120 beats per minute. For children over one year old, at least 100 blows.
Before the ambulance arrives, put the child to bed, ensuring him peace, however, try to keep him awake for about 1-2 hours to assess his condition, otherwise you may underestimate the severity. If your child is unconscious or vomiting, place him or her gently on their side so that vomit does not enter the respiratory system.
However, if there is a suspicion of injury to the back and spine (a fall from a height onto the back), the child should not be touched, as this may lead to displacement of bone fragments and additional damage.
Loss of consciousness, even for a very short time, slowing of the pulse, lethargy, and yawning are dangerous. Sharp crying, refusal to eat, nausea and vomiting, regurgitation, strange behavior that did not exist before. All these symptoms are a reason to at least consult a traumatologist or neurologist.

Head injuries.

These are some of the most dangerous injuries, along with spinal injuries. The brain and spinal cord are life-supporting organs; the entire functioning of the body depends on them. The baby’s skull is designed in a special way, it has fontanelles and sutures, but it is very fragile, and brain damage from an impact is higher than in an adult. Due to the sutures, bones can easily move, and the baby’s restlessness, combined with his lack of coordination and reduced sense of fear, can lead to trouble. In addition, children do not know how to fall correctly and often do not put their hands up for protection and hit their heads.
Traumatic brain injury in children is one of the serious diagnoses that occurs when falling and hitting their head. It is not always easy to identify the moment of trauma, especially if the child was left with older children, relatives, or a nanny; they could hide it from their parents, fearing punishment or other problems. Older children often keep silent about the injury; in addition, sometimes there are injuries without a head impact. One example is “shaken baby syndrome,” which occurs when children are handled roughly, jumping from a height, or under sudden acceleration or braking.
So, let's divide all head injuries by severity.
The mildest is considered to be a soft tissue bruise or, in the common term, a “bump.” In this case, the brain tissue does not suffer in any way, but tissue swelling and abrasion form at the site of the impact. If the “bump” is large, show the child to a traumatologist - sometimes cracks in the bones of the skull can be hidden under the mask of edema.
If the brain is injured, it is called a traumatic brain injury. If the integrity of the tissues of the head (skin and bones of the skull) is damaged, this is an open injury, while if the meninges are also damaged, this is a penetrating wound of the head. This also poses a threat of brain infection, which will worsen the prognosis.
Closed TBI is an injury with minimal soft tissue damage and no bone trauma. Typically, these injuries most often occur in children. These injuries are divided into three groups according to severity:
- mild degree (concussion),
- moderate severity (brain contusion)
- and severe (compression of the brain, fracture of the base of the skull, severe brain contusions).

Manifestations and diagnosis.

To our great joy, moderate and severe injuries are rare; they are recognized quickly and usually in an ambulance. But I want to talk specifically about concussions - they happen quite often. A concussion is manifested by a short-term loss of consciousness, vomiting appears, many times in the first months of life, children turn pale, sweat, and are lethargic. Usually the baby begins to refuse food and complains of headaches or tinnitus.
Dangerous and requiring an immediate call for an ambulance are: nosebleeds after a head injury, loss of consciousness for any period of time, breathing and heart rhythm disturbances, discharge of light fluid from the ear, and the appearance of bruises around the eyes.
In the hospital, the child will undergo an ultrasound of the head (if the fontanel is not closed) and an x-ray. If you need a tomogram with a set of other studies, up to a puncture. This will allow you to accurately diagnose and carry out the treatment prescribed by the doctor.