Causes of severe intestinal bleeding in an infant. Internal bleeding

Children's health is extremely important important role, so parents need to be especially attentive to the well-being of their children and pay attention to the development various violations well-being. Doctors say it is better to be overly vigilant than to ignore various warning signals from the body. One of the frightening conditions faced by pediatricians and gastroenterologists is bleeding from digestive tract in children.

Such bleeding in children can have different causes, and in any case they are a rather alarming symptom. The main unifying symptom of such conditions is the appearance of bloody vomiting or bloody stools; such symptoms can be combined. If the bleeding is not pronounced, and the blood remains in the stomach for a relatively long time, the vomit becomes like coffee grounds. And with heavy bleeding, scarlet blood can be seen in them. After about eight to ten hours, or when blood is ingested, tarry stools are detected. If bleeding occurs from the lower parts of the intestine, then little changed (scarlet) blood can be seen in the child’s stool.

The type of bleeding from the digestive tract and its causes are largely determined by the age of the children.

Between the ages of three and seven years, bleeding is most often provoked by colon polyposis. And in children over seven years of age, they find varicose veins veins, esophagus or stomach, as well as ulcerative lesions of the stomach or duodenum, erosive and allergic form gastritis.

In addition, gastrointestinal bleeding in children can occur with many blood diseases, including hemophilia, hemorrhagic vasculitis, Wergolf disease, leukemia, applastic anemia, etc.

Dangerous symptoms bleeding

The classic manifestation of bleeding from the digestive tract in children, as we have already written on this page “Popular about health”, is bloody vomiting or bloody stool. If the bleeding is profuse, it is accompanied by thirst, drying of the mucous membranes oral cavity, rapid progression of weakness and dizziness. Loss of consciousness is also possible. The skin turns pale, and cold sweat, limbs become cold. Patients may become agitated or prostrated, and their facial features sharpen quite quickly. Sometimes yawning, nausea and repeated vomiting occur.

Pathological processes lead to increased heart rate, but it has weak filling. Over time, the pulse becomes thread-like, breathing becomes more frequent, and blood pressure drops.

The appearance of the described symptoms is a reason for immediate and hospitalization in an inpatient department. Young patients with bleeding from the digestive tract are usually sent to the surgery department.

Treatment of bleeding

Transportation of patients with bleeding should be carried out with extreme caution. The child is placed on his back, and on upper half An ice pack is placed in the abdomen. In case of severe bleeding, blood transfusions are carried out, intravenous infusions of solutions are also carried out. At the same time, administration is carried out vitamin preparations– vitamins K, PP and C.

If bleeding continues, doctors raise the question of whether surgical intervention– to find the source of bleeding and eliminate it.

On the first day after the bleeding stops, children should not be fed. They are shown intravenous administration glucose in combination with saline solution. The next day, doctors prescribe the Meulengracht diet, which consists of thoroughly pureed vegetable purees (they are mixed with pureed meat or fish), cooled milk, eggs, and cream.

Of course, in parallel, doctors carry out active treatment underlying disease.

Uncomplicated bleeding from the lower parts of the digestive tract (with anal fissures or hemorrhoids) can be successfully treated at home - after a full examination, selection proper therapy And dietary nutrition.

Surgical treatment bleeding from the digestive tract in children

Sometimes it is possible to cope with bleeding or prevent its reoccurrence only with the help of surgery. It can be open, or involve a series of minimally invasive procedures. The latter include methods for treating bleeding caused by gastritis and ulcerative lesions gastrointestinal organs. In such situations, the doctor may decide to perform endoscopic intervention– for cauterization or pricking of affected areas. But such measures do not always give lasting results. positive effect, in this case you cannot do without open surgery for suturing the problem area.

Also surgery It is also carried out if bleeding has developed due to diverticulosis and some other pathologies.

It is worth noting that the appearance of any significant bleeding from the digestive tract in a child is a reason to immediately call an ambulance.

The question of why a child may be bleeding is not easy to answer. There can be many reasons for bleeding. In other words, bleeding is a symptom large number diseases. In order to understand what is going on, it is necessary to understand the nature of the outpouring. It could be:

• traumatic, that is, one that arose due to traumatic injury blood vessels(blow, injection, laceration);
• non-traumatic, that is, one that arose due to corrosion vascular wall the center of the disease.

Symptoms

The first signs of bleeding are the appearance of blood where it should not be. However, one must understand that the outpouring does not always happen outside. Bleeding may also occur internally. child's body. In order to understand in time what is happening, it is necessary to pay attention to the child’s secretions. A simple example is gastrointestinal bleeding, which can be diagnosed by bloody vomiting or bloody stool. But do not forget: blood can enter the digestive tract not only due to diseases of the organs of this system. The effusion may occur in another location, such as the lungs. And after that it gets into the stomach.

Parents should know that in case of any alarming symptom, it is necessary to call a doctor or go to an appointment with him to find out the causal circumstances of the child’s unhealthy condition.

To understand the symptoms of hemorrhage, you also need to know that this phenomenon is divided into several types according to clinical manifestations:

• external bleeding - when blood flows out of the body, that is, into the external environment;
• cavitary or internal bleeding - a hidden effusion during which blood penetrates into one or more internal organs or abdominal parts of the body (the most common cause of such bleeding in children is gastrointestinal diseases, especially ulcers).

Diagnosis of bleeding in a child

It is not difficult to detect external hemorrhage. It is impossible not to notice the red liquid released from the child’s body. But how to diagnose internal bleeding? By what signs can it be recognized?

First signs internal bleeding the child's are:

• weakness,
• drowsiness,
• pallor skin,
• cold sweat,
• constant thirst,
• possible fainting.

You can find out if your baby is bleeding internally by measuring his pulse. If the blood loss is insignificant, the pulse will increase to eighty beats per minute. If the effusion is characterized by moderate severity, then the pulse per minute will be from ninety to one hundred beats. If the case is severe, the pulse can rise to one hundred and ten beats within sixty seconds.

Bleeding that threatens the life of a child has the following symptoms:

• decline systolic pressure up to sixty millimeters of mercury,
• convulsions,
• severe bradycardia,
• coma,
• dryness and coldness of the skin,
• pupil dilation.

Complications

The following may occur due to bleeding:

• the tissues of the child’s body will no longer be supplied with blood in the required quantity;
• a small patient will lose too much blood;
• organs will no longer be supplied with oxygen to the required extent, as a result of which their functions will be seriously impaired.

Treatment

What can you do

If parents suspect internal bleeding in their child, they should immediately consult a doctor. In this situation, they, without proper experience and medical education, can only help their child in this way.

If the bleeding is external, mom and dad, as well as those around them who notice the bleeding, can easily provide first aid to the baby. In the vast majority of cases, a bandage helps stop blood loss. It is noteworthy that the children’s body is able to stop the outpouring on its own. If the child is less than three years, in case of bleeding, a pressure bandage is relevant. If a small patient is more than three years old, it is important to use a tourniquet. It is worth knowing that such a tourniquet differs from an “adult” tourniquet in its increased elasticity.

The most common mistakes when applying a tourniquet:

• the use of this method of stopping bleeding is unfounded (a tourniquet is relevant for arterial effusion),
• applying a tourniquet too far from the injured area,
• application on a naked body,
• too tight or too loose.

What can a doctor do?

Bleeding is not a disease. This is a symptom painful condition. That is why the treatment of bleeding involves the fight against the disease, which provoked a violation of the integrity of the blood vessels.

The main goals of first aid for bleeding are:

• stopping bleeding in a child,
• replenishment of lost blood,
• treatment of coagulopathy,
• prevention of recurrent hemorrhage,
• prevention of deterioration of liver function.

If a small patient with internal bleeding comes to the doctor, the doctor examines him, talks with relatives and the child himself, and then prescribes a series of laboratory research and analyses. The main task is to determine what exactly provoked the violation of the integrity of the blood vessels.

If a child with external arterial bleeding, the doctor, with the help of nurses or orderlies, will do what the parents did not have time to do - apply a special bandage. For this purpose, the doctor will apply sterile gauze to the area of ​​the body that is bleeding. Afterwards, a bandage is applied on top, folded several times. As soon as pressure bandage will be pressed, the outpouring of blood will stop.

If for age little patient It is more important to apply a tourniquet instead of a bandage, the doctor will do just that. By applying a tourniquet correctly, the hemorrhage will be stopped immediately. Next, the doctor will decide other issues. Namely, to treat what provoked the violation of the integrity of the blood vessels.

Prevention

Preventive actions, designed to prevent the development of bleeding in children, directly depend on the cause of the bleeding. Main preventative measure aimed at reducing the risk of external bleeding - storing cutting and piercing objects away from children.

Ministry of Education of the Russian Federation

Penza State University

Medical Institute

Department of Therapy

"Bleeding in Children"

Penza

Plan

Introduction

1.Nose bleed

2.Bleeding from the digestive tract

3.Pulmonary hemorrhage

4.Bleeding from the kidneys and urinary tract

Literature

Introduction

Bleeding and increased bleeding in children are quite common. The causes of bleeding in children are different: traumatic and non-traumatic (increased fragility of the vascular wall, dysfunction of platelets, coagulation and anticoagulation systems, etc.). By clinical manifestations bleeding can be divided into external and internal; depending on the nature of the vessels, it can be arterial, venous, mixed, capillary (parenchymal).

1. Nosebleed

Often occurs in children and can be a consequence of trauma (blow, damage to the mucous membrane with a finger, etc.) or a sign general disease(hemophilia, thrombocytopenia, Osler disease, von Willebrand-Jurgens disease, hemorrhagic vasculitis, hypovitaminosis C and K, circulatory failure, etc.). Nosebleeds can occur with infectious diseases(measles, whooping cough, ARVI, influenza, sepsis, etc.), local inflammatory and productive processes (polyps, adenoids, neoplasms, etc.), increased blood pressure.

If you are predisposed to nosebleeds, the resolving factor may be: overheating, sudden head tilts, straining, etc.

Symptoms depend on the nature of the nosebleed (profuse or only an admixture of blood), the location of the bleeding area (anterior, posterior). If the mucous membrane of the anterior parts of the nose is damaged, the blood pours out; if the back parts of the nose are damaged, it is swallowed, simulating gastric and (or) pulmonary hemorrhage. The color of the blood is bright red. If blood is swallowed, bloody vomiting may occur. In cases of heavy bleeding, pallor, lethargy, dizziness, and tinnitus appear.

Urgent Care. Absolute rest, in a half-sitting position with the head moderately thrown back. It is forbidden to blow your nose. Ice or gauze soaked in water is placed on the bridge of the nose. cold water. Tampons moistened with a solution of 3% hydrogen peroxide, thrombin, or hemostatic sponge and press them against the nasal septum. If the bleeding does not stop, anterior nasal tamponade is performed with a swab moistened with the same solutions. For persistent and prolonged bleeding, posterior tamponade is indicated. At the same time, a 10% solution of calcium chloride or calcium gluconate (1-5 ml intravenously according to indications), rutin (up to 1 year - 0.0075 g, 1-2 years - 0.015 g, 3-4 years - 0.02 g) is prescribed orally ., 5–14 years – 0.03 g per day), vitamin C, Vicasol for 3 days, 3–15 mg per day. In case of heavy and persistent bleeding, blood transfusion (including direct) is indicated.

Hospitalization. If the above measures are ineffective, the child must be hospitalized in the otolaryngology department.

2. Bleeding from the digestive tract

The main unifying symptom of bleeding from the digestive tract is bloody vomiting or bloody stools, which are often combined. At slight bleeding and the relatively long stay of blood in the stomach, the vomit looks like coffee grounds, in cases heavy bleeding they contain scarlet blood. After 8–10 and when blood is swallowed, tarry stools are detected. When bleeding from the lower intestines, the stool contains little changed blood. The nature and causes of bleeding from the digestive tract in children largely depend on the age of the child. So, by manifestation hemorrhagic syndrome serves as melena of newborns. In children 1–3 years of age, the most common cause bleeding occurs intussusception, Meckel's diverticulum and duplication of the intestine, hernia hiatus diaphragm, from 3 to 7 years – colon polyposis, over 7 years – varicose veins, esophagus and stomach, peptic ulcer stomach and duodenum, erosive and allergic gastritis.

MELENA OF NEWBORNS is caused by diapedetic bleeding from the capillaries of the stomach or intestines; it is more common in children in the first week of life. It begins suddenly with vomiting of blood and blood in the crimson-colored stool. General state may not change, but in some cases melena develops severely against the background of severe anemia and continuous bleeding from the anus. Differentiate from false melena (swallowing of blood from cracks in the mother’s nipples or from the child’s mouth).

Urgent Care. 0.2 ml of a 1% solution of Vikasol is administered intramuscularly (no more than 4 mg per day), a fresh blood transfusion is performed, or direct transfusion it in the amount of 10–15 ml/kg, depending on blood loss.

Hospitalization in all cases of melena is emergency in the neonatal department.

MECKEL'S DIVERTICULUM AND DUPLICATION OF THE INTESTINE. When the mucous membrane of Meckel's diverticulum is ulcerated, intestinal bleeding is observed, often profuse, occurring among full health, repeated at intervals of 3–4 months, which leads to anemia, pallor, tachycardia, and collapse. The first stools are usually dark in color, followed by dark (scarlet) blood without clots or mucus. Unlike gastrointestinal bleeding Meckel's diverticulum does not cause bloody vomiting of any other origin. The diagnosis is made by exclusion. When the intestine is doubled, bleeding from the intestine occurs in almost 1/3 of all cases. X-ray contrast study is required gastrointestinal tract with barium.

Urgent Care. The patient should not be fed. Vikasol is prescribed to children under 1 year 0.002–0.005 g, up to 2 years 0.006 g, 3–4 years – 0.008 g, 5–9 years – 0.01 g, 10–14 years – 0.015 g, 2 possible –3 times orally (1 tablet – 0.015 g) or intramuscularly 1% solution (1 ml – 10 mg); intravenously 1–5 ml of a 10% solution of calcium gluconate or calcium chloride with ascorbic acid (1–3 ml of a 5% solution).

Hospitalization in a surgical hospital (for trial laparotomy) in case of repeated and persistent bleeding.

HEAT HERNIA. This disease in children often manifests itself as persistent vomiting mixed with blood, iron deficiency anemia, the presence of blood in the stool (usually hidden) as a result of erosive-ulcerative esophagitis and gastritis. Constant dysphagic phenomena, pain behind the sternum, attacks of cyanosis, shortness of breath, cough, children are behind in physical development, pale. Percussion detection of areas of tympanitis in chest, displacement of the borders of the heart in the direction opposite to the hernia during auscultation in chest cavity manages to listen intestinal peristalsis, rumbling.

Urgent Care. Compliance with the diet, Vikasol (see doses above), ascorbic acid, calcium supplements (gluconag or calcium chloride orally or intravenously 1-5-10 ml of 10% solution), in case of severe anemia - blood transfusion.

Hospitalization in all cases of suspected diaphragmatic hernia to the surgical hospital. The diagnosis is confirmed by x-ray examination.

INTESTINAL POLYPOSIS. Occurs more often in children and age 36 years, localized in lower parts large intestine. Bleeding can range from mild to heavy, life-threatening patient (with spontaneous tearing off of the toe), occurs during or after the act of defecation. Even with insignificant but constant allocation blood appears pallor of the skin, weakness, tachycardia, indicating anemia. The diagnosis is made when digital examination rectum, sigmoidoscopy and irrigography. With hereditary polyposis (Peutz-Jeghers syndrome), pigmentation is found around the mouth and on the mucous membrane of the oral cavity.

Urgent Care. Maintaining a gentle diet, prescribing calcium chloride and ascorbic acid.

Hospitalization in a surgical hospital for any bleeding from the rectum.

VARICOSE VEINS OF THE ESOPHAGUS AND STOMACH. Occurs with portal hypertension. In children, the predominant extrahepatic form of portal hypertension is caused by developmental anomalies portal vein or thrombosis of the portal system vessels due to pylephlebitis; The causes of the intrahepatic form of portal hypertension in children can be cirrhosis and congenital fibrosis of the liver. Bleeding more often occurs in older children from the veins of the cardial part of the stomach, in these cases it is always threatening, since at the same time, due to liver damage, there are disorders of the blood coagulation system. There is a lot in vomit and feces dark blood. Diagnosis is helped by anamnesis (the presence of liver diseases), enlargement of the spleen (possible only in the anamnesis, since against the background of bleeding the spleen can decrease in size and then increase again), examination (dilation of the veins of the anterior abdominal wall, liver enlargement, erythema of the palmar surface of the hands, spider veins on the skin of the face, chest, icterus); in blood tests - the phenomenon of hypersplenism (decrease in the number of platelets, leukocytes, erythrocytes). Differentiate with portal hypertension due to intranasal sepsis, suppurative processes in abdominal cavity, Chiari disease (suprahepatic portal hypertension), lymphogranulomatosis.

Urgent Care. Place the child in a position with the head elevated and turned to one side to prevent aspiration of vomit. It is necessary to adequately and quickly compensate for blood loss: with blood loss up to 15 ml/kg, you can transfuse donor blood (7–10 ml/kg), rheopolyglucin (10–15 ml/kg) in combination with saline solutions(10 ml/kg); for blood loss of 16–25 ml/kg - transfusion of plasma replacement solutions and donated blood in a ratio of 2:1, with blood loss of 26–35 ml/kg and above, their ratio is 1:1 or 1:2. The total volume of transfusions should exceed blood loss by an average of 20–30%. In the hospital, the veins of the esophagus are compressed using a Blakemore zone, sclerosing drugs (varicocid) can be administered through an esophagocop, and oxygen is started early into the stomach and intestines through a tube until slight swelling epigastric region and tympanic percussion sound. If unsuccessful conservative treatment Surgery is indicated within 2 days.

Opening internal bleeding is a health and life-threatening condition that occurs due to various 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 ends up in certain places inside. This could be the uterus in women, the space between the joints, the stomach, bladder, lungs, intestines.

Symptoms this 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, shock) and chronic illness.

The danger of this phenomenon is increased by untimely provision of first aid, ignoring signs by patients, and late diagnosis.

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

Symptoms of pathology

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

The patient becomes very sick and vomits blood if the pathology is in the gastrointestinal tract. Diarrhea occurs when there is internal bleeding in the upper esophagus or small intestine. If there is a lesion in the large intestine, red discharge will come from the anus.

Gastrointestinal intestinal bleeding- one of the most dangerous. Symptoms include fever, and the patient may feel abdominal pain. If, then the person is tormented by a strong bloody cough, and the place of accumulation of secretions is the pleural cavity. Shortness of breath appears, there is not enough air.

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

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

1. Deterioration in health.
2. Sudden weakness, lethargy, apathy.
3. Chills, heat, 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 its complete absence.

If no one is nearby, you must call the ambulance service, then take 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 cannot take any pills or drink water. You need to apply ice to your head, chest, and stomach. It is important to try not to panic or make sudden movements.

Common signs of bleeding

The main signs for all forms of bleeding occurring inside the body: weakness in the body, lethargy, arterial pressure(BP) decreases significantly, the skin turns pale, and cold sweat appears.

Suspicion of similar condition should occur if there were provoking factors (impacts with blunt, piercing objects; injuries), diseases of the internal organs were diagnosed.

The patient may lose appetite and feel extreme thirst, even lose consciousness. How serious a person’s condition is can be recognized by certain signs.

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

If bleeding medium degree, upper 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, and all psychomotor reactions slow down.

In severe cases, the patient’s blood pressure drops significantly, the pulse is rapid, breathing is intermittent, cold sweat appears, drowsiness appears, trembling of the arms and legs, the eyes darken, vomiting begins, the skin turns pale, cyanosis develops, and 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 become 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 disease is damage to the artery by a sharp, cutting object, gunshot wound; trauma resulting from blunt impact.

It is very difficult to stop bleeding on your own. Blood flows like a fountain inside and outside the organs; 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, and spleen.

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

Venous is formed if the walls of the veins are damaged. The patient immediately develops symptoms of anemia, anemia, and state of shock. Venous bleeding may cause dangerous conditions, in which the escaping fluid accumulates in the pleural and retroperitoneal cavities.

Causes

Why does it occur similar pathology? 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, incorrect location of internal organs, their displacement, enlargement due to illness;
• during pregnancy - ovarian rupture, cysts, ectopic location ovum;
• decay malignant tumor;
• arterial hypertension, atherosclerosis.

There can be many more reasons, so it is important to respond in a timely manner 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 feels bad, how to find an objective sign of internal bleeding and recognize its source?

If hemorrhage occurs in the abdominal cavity, followed by a rupture of the spleen or liver, then general symptoms include dizziness, weakness, low blood pressure and tachycardia. The patient experiences heaviness in the abdomen, pain in the left and right shoulder, and upon palpation of the peritoneum there is pain in the upper part.

It is difficult, but possible, to independently determine bleeding and its nature..

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

When bleeding occurs in the retroperitoneal space (ruptures of the kidneys, aorta), the patient experiences general symptoms, which are not very pronounced.

There is pain in lumbar region, if you lightly tap on the spine, it will intensify.

If the lesion is in the stomach or intestines, then bloody vomiting or diarrhea and no abdominal pain are observed.

How to stop bleeding

If there is a suspicion of internal hemorrhage, then the first health care at home will play an important role in 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 a window in the room and apply cold to the suspected area of ​​damage.

It is important to control a person’s breathing and pulse. If he gets worse, artificial respiration needs to be done and carried out.

Do not give painkillers, water, medicine, stretch the body, tightly bandage the injury site, or move the victim.

Drug therapy

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

Doctors first stop the blood, replace its loss, and improve circulation. Use physical solutions, glucose, the rest medications are prescribed according to the patient's condition.

In what cases is surgery required?

Surgery is necessary if the patient's condition is critical. After the person has been given first aid, he is hospitalized. Specialists take into account the source of bleeding, and then take measures.

If the place of concentration of fluid is the pleural cavity, then the treatment is carried out by traumatologists, if the lungs are treated - by surgeons, in case of intracranial damage - by neurosurgeons, in case of uterine damage - by gynecologists.

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

The main task of the doctor is to stop the bleeding, compensate for the amount of loss and improve blood supply. Patients often experience shock, in which internal organs do not receive enough oxygen.

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

At pulmonary hemorrhage bronchial tamponade is performed. If filled with blood abdominal part, then an urgent laparotomy is performed. If the damage is intracranial, then trepanation is performed. In case of an ulcer, damaged vessels are removed; in case of cracks in the intestines, surgery is performed and they are sutured.

If a woman has ectopic pregnancy(a pipe rupture has occurred), then the pathology is eliminated only surgically.

Internal bleeding during pregnancy

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

Clinical manifestations of this condition:

• discharge can be abundant, average, or absent altogether;
• pain in the lower abdomen, the uterus “turns to stone,” which is easy to feel upon palpation;
• the cardiac activity of the fetus is disrupted, hypoxia occurs (determined by ultrasound);
• The woman's body temperature rises.
• health worsens.

Detachment is provoked by maternal alcohol consumption, drug addiction, smoking, anemia, low red blood cell count, abdominal trauma, allergies to medications, fluctuations in blood pressure.

Consequences

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

If blood gets into the cavities of internal organs, their activity is disrupted. If the vessels are compressed, tissue necrosis occurs. Blood that remains in the cavities of organs for some time (not circulating) becomes suitable place for the proliferation of bacteria and the development of infections.

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

Detecting internal bleeding is very difficult. On initial stage its symptoms are very vague and similar to those of other diseases. Something is wrong can be suspected when there are severe external injuries, but some chronic diseases also cause a similar condition. The danger is that a person does not always experience pain. However, if you do not accept urgent measures, the life of the sufferer will be at risk. How to recognize signs of internal bleeding and how to help before doctors arrive? Read about this later in the article.

Types of internal bleeding and their manifestations

Significant internal loss bleeding occurs for two reasons:

• mechanical damage to internal organs due to impact, fall from height, work injury or even after a showdown with fists;
• chronic diseases that lead to thinning of the walls of blood vessels and their rupture. In this case, blood fills either a natural cavity (stomach, uterus in women, lungs) or a cavity created by it.

No matter how much blood is poured out, the body strives to push it out. She goes out with feces, stomach contents, from the internal genital organs in women, expectorated with sputum from the bronchi and lungs. However, you should not think that the bleeding will stop on its own; the wound will heal on its own. At the first manifestations of internal blood loss, you should consult a doctor as soon as possible.

Gastrointestinal

According to doctors, cirrhosis of the liver, ulcers, varicose veins of the stomach or duodenum provoke every third internal bleeding. In this case, you can recognize the problem by vomiting mixed with bloody clots of a dark, almost black color. Another characteristic feature internal bleeding into the digestive organs - stool that resembles tar in color and consistency. It can appear 1–2 or even 9–10 hours after the onset of blood loss.

Cranial

Otherwise, this type of internal bleeding is called a stroke. In this situation, the fluid does not find a way out and accumulates in the skull. Delete blood clots can only be done surgically. The danger of blood clots in the brain cannot be underestimated: they can cause complete or partial paralysis, disruption of the functioning of those organs for which the affected area is responsible, and even fatal outcome. In addition to severe head injury, stroke often results from:

• high blood pressure;
• diabetes;
• brain tumors;
• vascular aneurysm;
• encephalitis.

Small pelvis

It's about O uterine bleeding. It can occur in women for various reasons. Changes hormonal levels, tumors, ectopic pregnancy, miscarriage, placental abruption during pregnancy, rupture of the uterus or ovaries - all these factors hidden from human eyes provoke internal bleeding. They may open after or during your period. One of the signs of internal bleeding is blood coming out profusely in the form of large clots dark color. Accompanied by the process aching pain in the lower abdomen.

In the abdominal cavity

Severe internal bleeding in this area is possible for various reasons:

• ectopic pregnancy;
• tumors;
• low blood clotting.

What makes bleeding of this type special is the fact that a person, experiencing sharp pain in the peritoneum, in order to calm it down a little, I have to sit with my knees pulled up to my chest. Most often, doctors encounter external mechanical damage:

• abdominal injuries;
• chest injuries;
• ruptures of internal organs: liver, ovaries, spleen.

In the respiratory system

The accumulation of blood in the lungs and its release is associated with complications after certain diseases (tumors in the chest, tuberculosis), with injuries to the ribs, heart and respiratory organs themselves. At the same time, along with typical characteristics, there are also some specific signs:

• The pulse rate decreases noticeably with heart injuries and increases if the lungs are damaged;
• difficulty breathing, lack of oxygen if the blood has filled pleural cavity;
• there are chest pains of varying strength;
• characterized by restless behavior, distortion of facial features;
• cough is accompanied by the release of scarlet blood mixed with foam.

Main signs and symptoms

Along with specific ones, experts note numerous general symptoms internal bleeding, regardless of which specific organ or part of the body is affected. These signs include:

• severe dizziness;
• inability to exercise everyday affairs, weakness;
• unnatural pallor of the skin and whites of the eyes;
• apathy, drowsiness, inability to concentrate;
• nausea, vomiting;
• fainting;
• especially severe cases are marked by confusion, inability to adequately perceive and respond to what is happening;
• with injuries incompatible with life, the person falls into a coma.

By some signs you can judge which vessels are damaged. Capillary bleeding is very weak and does not pose any particular danger to life. Parenchymal, in which all channels are involved, is very long-lasting and abundant. Arterial is characterized by the release of bright red blood, and it flows jerkily. The main signs venous bleeding– slow, uniform flow of dark-colored blood.

First aid for internal bleeding

It is difficult to determine the source of internal bleeding without examining a doctor. However, if the sufferer is left without help at all, the situation can significantly worsen. Some simple actions will alleviate the condition of the victim and give him a chance for a successful outcome:

• try to provide the victim with peace and maximum possible comfort;
• if, based on some signs, you can assume that internal hemorrhage occurred in top part body, arrange the person reclining. Otherwise, lay on your back;
• make sure that the victim moves as little as possible;
• put something cold (a bag of frozen food, cold water, ice cubes) to the area where you think internal bleeding is occurring;
• You should not give the sufferer any medications, drinks other than water, or carry out any procedures. What is necessary in each specific case can only be determined by a specialist;
• do everything so that the doctor arrives as soon as possible.

By watching the video below, you will learn how to properly assist a person suffering from internal bleeding on the street. A professional doctor tells how to competently, armed with the familiar items at hand, relieve a patient’s suffering before the emergency doctor appears. You will learn about the first symptoms of internal bleeding, which will give you a signal to act, because such a problem should never be left to chance.