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Intra-abdominal Hematoma : Causes, Symptoms, Diagnosis, Treatment, Prevention



A hematoma is a collection of blood outside of a blood vessel.
There are several types of hematomas and they are often described based on their location. Examples of hematomas include subdural, spinal, under the finger or toenail bed (subungual), ear, and liver (hepatic).
Intra-abdominal hematomas and hemorrhage may be due to a variety of injuries or illnesses. Regardless of how the blood gets into the abdomen, the clinical finding is peritonitis (irritation of the lining of the abdomen). Hematomas may occur in solid organs such as the liver, spleen, or kidney. They may occur within the walls of the bowel, including the small intestine (duodenum, jejunum, and ileum) or the large intestine (colon). Hematomas may also form within the lining of the abdomen called the peritoneum or behind the peritoneum in the retroperitoneal space.
Some causes of hematomas are as pelvic bone fractures, fingernail injuries (subungual), bumps, passing blood clots, blood clot in the leg (DVT), blood cancers, and excessive alcohol use.
Symptoms of hematomas depend upon their location and whether adjacent structures are affected by the inflammation and swelling associated with the bleeding and may include:
  • Headache,
  • Confusion,
  • Seizures in case of subdural hematoma,
  • Back pain,
  • Loss of bladder or bowel control (epidural hematoma),
  • Discoloration,
  • Nail loss,
  • Pain in the nail bed, and
  • Abdominal or flank pain (spleen, liver, or peritoneal hematoma).

Treatment of a hematoma depends upon which organ or body tissue is affected.

Superficial hematomas of the skin and soft tissue, such as muscle, may be treated with rest, ice, compression, and elevation (RICE). Heat may also be considered.

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