Parenchymal bleeding occurs when injured. Stopping parenchymal bleeding

Parenchymal bleeding is the process of hemorrhage into the body cavity, that is, internal. Such a phenomenon can provoke mechanical damage or some forms of disease. Such a condition can be dangerous to human life and health. With a severe internal hemorrhage, such as after a car accident, a person needs surgery to help save a life.

General characteristics of internal bleeding

Such bleeding occurs when the tissues of the internal organs are injured. Diagnosis of this condition is usually very difficult.

The most common bleeding occurs:

due to mechanical damage;
as a result of neoplasms;
due to severe illness.

Symptoms may be hidden or mild, so if you suspect the development of such a process, you should immediately contact a specialist. The medical institution will conduct a full examination, which will identify the cause and make predictions.

Fatal blood loss is approximately 2.5 liters for an adult. In this case, a blood transfusion is performed to save a person's life. Transfusion is carried out during the operation and for several days after it. As a result of large blood loss, there is a slow heartbeat, a decrease in red blood cells and other important substances that make up the blood.

The general condition of a person worsens, severe pain appears. The metabolic process is disturbed, the body begins to suffer, experience severe stress. In the event of such a problem, you should immediately seek medical help.

What organs can suffer from such a problem

Parenchymal bleeding usually occurs in the following organs:

liver;
kidneys;
lungs;
spleen.

The peculiarity of these organs is that they consist of a thick and blood-supplied parenchyma. This is due to the fact that the main functions of organs is the filtration of substances unnecessary to the body.

This type of bleeding can occur:

due to mechanical damage, in which tissue ruptures occurred;
due to diseases of the organs, in particular - due to the appearance of tumors;
due to infectious lesions;
as a result of cancer.

Poor blood clotting can aggravate the situation. Patients who suffer from poor blood clotting are at risk, since hemorrhage can occur not only from mechanical damage, but at any time.

In this case, the blood loss may be insignificant and not cause much harm to the patient's health, in another case, the bleeding may be so severe that it will be impossible to stop it without an emergency operation. As a result of this phenomenon, there is a sharp decrease in the content of red blood cells and iron in the blood, which leads to oxygen starvation.

With heavy bleeding, the patient may experience hemorrhagic shock. Rapid blood loss leads to cardiac arrest and death.

State Danger

Parenchymal bleeding is a life-threatening and health-threatening condition. With this phenomenon, blood flows into the surrounding tissue, organ cavity, body cavity.

According to the type of bleeding are divided into the following types:

venous;
capillary;
arterial.

The first type is formed when the liver is injured, it is distinguished by characteristic clinical manifestations that quickly begin to develop. With this type of hemorrhage, there is a high probability of developing hemorrhagic shock.

The capillary type develops rather slowly, so its onset is often missed. Blood flows out in small portions, which leads to a sharp decrease in iron and red blood cells in the body. In addition, an inflammatory process develops in the abdominal cavity.

The danger of the condition lies in the fact that the parenchymal organs are not capable of self-stopping blood, which requires surgical intervention. The impossibility of the organs to provide the process of stopping the blood is due to their structure and the absence of spasm of the vessels passing inside their tissues.

This condition causes irreversible consequences in the patient's body. The person feels unwell, feels weak and dizzy. If blood loss is not stopped in a timely manner, the body will die.

Clinical manifestations of the disease

Such bleeding, which develops quickly enough, immediately declares itself. However, if the bleeding is slow, then clinical manifestations may be absent or completely invisible.

Symptoms of this condition include:

severe and rapid fatigue;
dizziness;
constant desire to drink;
pallor of the skin;
chills;
pressure drop.

In addition, there are special clinical manifestations that occur depending on the affected organ.

Particular attention should be paid to the following conditions:

expectoration with blood;
acute pain in the abdominal cavity;
change in the color of urine;
the appearance of pressure in the chest;
dyspnea.

The appearance of bleeding in the lungs often appears when the ribs are fractured, when sharp bones pierce the tissues of the respiratory system. And also the defeat can be caused by tuberculosis or oncology.

The spleen most often ruptures due to mechanical trauma (for example, as a result of an accident). In this case, immediate surgical intervention is required, any delay can cost the patient's life.

The kidneys are susceptible to injury when squeezing or rupturing neoplasms. In this condition, urine is sharply stained, severe pain is observed.

In any case, the condition requires the immediate intervention of specialists. If symptoms of internal bleeding are observed, an ambulance should be called immediately.

First aid and surgery

First of all, you should pay attention to the following manifestations:

the presence of injuries of the abdominal cavity;
mechanical damage to the chest;
the formation of hematomas and bruises;
sharp pain in the area of the damaged organ;
emerging sweat;
chills and fever;
cardiopalmus;
a sharp drop in pressure.

If such a condition is suspected, the patient should be taken to the hospital as soon as possible, since it is impossible to stop such a process outside the hospital.

Before the doctors arrive, you must:

Lay the patient down and raise the legs.
Refrigerate the suspected injury site.

When the ambulance arrives, the specialists transport the victim to the hospital and administer to him such medicines as:

Etamzilat;
Vikasol;
Aminocaproic acid.

Medicines will not be able to stop the bleeding, but they will improve the patient's condition. In order to maintain pressure, specialists will begin to inject a special solution intravenously.

After the patient is taken to the hospital, he will immediately be taken to the operating room, where emergency procedures will be performed.

Before surgery, the following steps will be taken:

General analyses.
Ultrasound (ultrasound examination).
X-ray.

If all tests are within the normal range, the doctors will perform an emergency operation. Otherwise, a diagnostic laparoscopy is performed.

There are several ways to stop such a hemorrhage, among them are:

drying with a special sponge;
hemming of the omentum;
amputation of the affected part;
electrocoagulation;
sewing using special seams.

During the operation, a blood transfusion is performed, and this procedure is also done several times during the recovery process. In addition, saline is infused and supportive therapy is carried out to prevent the development of DIC (disseminated intravascular coagulation) and multiple organ failure.

Such bleeding usually becomes a threat to the life of the patient, therefore, does not tolerate delay. The sooner surgery is performed, the better the outcome will be. With a successful surgical intervention, the patient's life can be saved.

Contacting a medical institution

As soon as the victim is taken to a medical facility, specialists will begin to carry out the following activities:

Examine the patient for blunt or acute trauma.
Check for the development of an infectious disease.
Testing for oncology.
External examination and palpation.
Measurement of such basic parameters as pulse, pressure, temperature.

After a surgical intervention is performed (a way to stop parenchymal bleeding), the patient will have a long-term treatment in a hospital. Even surgical manipulations cannot always stop the development of this process. This is due to the fact that the organs have a specific structure with a very "delicate" structure.

During the recovery process, the patient is constantly transfused with blood, plasma and platelet mass. If the organ cannot be sewn up, then its amputation is carried out - complete or partial. The task of specialists is to prevent the patient from experiencing the shock of a large loss of blood. To do this, a procedure for restoring circulation is carried out.

Especially dangerous options are those when an internal hemorrhage of a mixed type occurs. In this case, the lack of medical care leads to the death of a person.

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

Parenchymal organs include:

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

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

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

The mechanism of blood loss and changes in the body

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

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

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

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

How to suspect

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

If shock is suspected, check the pulse

Features for each parenchymal organ

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

Liver

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

kidneys

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

Lungs

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

Hemoptysis is one of the signs of pulmonary hemorrhage

Spleen

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

How to suspect internal bleeding, what measures to take

What should be of concern:

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

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

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

Before the ambulance arrives:

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

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

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

Body position during pressure drop

Surgery

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

Ways to stop parenchymal bleeding:

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

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

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

Signs of parenchymal bleeding and first aid

General characteristics of internal bleeding

Such bleeding occurs when the tissues of the internal organs are injured. Diagnosis of this condition is usually very difficult.

The most common bleeding occurs:

due to mechanical damage;
as a result of neoplasms;
due to severe illness.

What organs can suffer from such a problem

Parenchymal bleeding usually occurs in the following organs:

This type of bleeding can occur:

due to mechanical damage, in which tissue ruptures occurred;
due to diseases of the organs, in particular - due to the appearance of tumors;
due to infectious lesions;
as a result of cancer.

Poor blood clotting can aggravate the situation. Patients who suffer from poor blood clotting are at risk, since hemorrhage can occur not only from mechanical damage, but at any time.

With heavy bleeding, the patient may experience hemorrhagic shock. Rapid blood loss leads to cardiac arrest and death.

State Danger

Parenchymal bleeding is a life-threatening and health-threatening condition. With this phenomenon, blood flows into the surrounding tissue, organ cavity, body cavity.

According to the type of bleeding are divided into the following types:

Clinical manifestations of the disease

Such bleeding, which develops quickly enough, immediately declares itself. However, if the bleeding is slow, then clinical manifestations may be absent or completely invisible.

Symptoms of this condition include:

severe and rapid fatigue;
dizziness;
constant desire to drink;
pallor of the skin;
chills;
pressure drop.

In addition, there are special clinical manifestations that occur depending on the affected organ.

Particular attention should be paid to the following conditions:

The spleen most often ruptures due to mechanical trauma (for example, as a result of an accident). In this case, immediate surgical intervention is required, any delay can cost the patient's life.

The kidneys are susceptible to injury when squeezing or rupturing neoplasms. In this condition, urine is sharply stained, severe pain is observed.

In any case, the condition requires the immediate intervention of specialists. If symptoms of internal bleeding are observed, an ambulance should be called immediately.

First aid and surgery

First of all, you should pay attention to the following manifestations:

the presence of injuries of the abdominal cavity;
mechanical damage to the chest;
the formation of hematomas and bruises;
sharp pain in the area of the damaged organ;
emerging sweat;
chills and fever;
cardiopalmus;
a sharp drop in pressure.

Before the doctors arrive, you must:

Lay the patient down and raise the legs.
Refrigerate the suspected injury site.

When the ambulance arrives, the specialists transport the victim to the hospital and administer to him such medicines as:

Medicines will not be able to stop the bleeding, but they will improve the patient's condition. In order to maintain pressure, specialists will begin to inject a special solution intravenously.

After the patient is taken to the hospital, he will immediately be taken to the operating room, where emergency procedures will be performed.

Before surgery, the following steps will be taken:

If all tests are within the normal range, the doctors will perform an emergency operation. Otherwise, a diagnostic laparoscopy is performed.

There are several ways to stop such a hemorrhage, among them are:

drying with a special sponge;
hemming of the omentum;
amputation of the affected part;
electrocoagulation;
sewing using special seams.

Contacting a medical institution

As soon as the victim is taken to a medical facility, specialists will begin to carry out the following activities:

Examine the patient for blunt or acute trauma.
Check for the development of an infectious disease.
Testing for oncology.
External examination and palpation.
Measurement of such basic parameters as pulse, pressure, temperature.

Especially dangerous options are those when an internal hemorrhage of a mixed type occurs. In this case, the lack of medical care leads to the death of a person.

Parenchymal bleeding

Description:

Parenchymal bleeding is the outflow of blood from the vessels of parenchymal organs.

Symptoms of parenchymal bleeding:

The blood vessels of the parenchymal organs are intimately connected with the parenchyma, so they do not collapse, bleeding is usually profuse, prolonged, stops with great difficulty. The peculiarity of these bleedings is massiveness due to abundant vascularization of the organ parenchyma.

Causes of parenchymal bleeding:

Parenchymal bleeding occurs when damaged parenchymal organs (liver, spleen, kidneys).

Treatment of parenchymal bleeding:

Stopping bleeding can be difficult and require the surgeon to use a variety of techniques. You have to use fibrin film, hemostatic sutures, electrocoagulation, etc.

Liver suturing as a method to stop parenchymal bleeding

Where to go:

Medicines, drugs, tablets for the treatment of parenchymal bleeding:

ZAO Bryntsalov-A Russia

Antihemorrhagic agents. fibrinolysis inhibitors.

LLC "Pharmaceutical company "Health" Ukraine

What is dangerous parenchymal bleeding and ways to stop it

Injuries to the abdomen or chest can result in parenchymal bleeding that is invisible from the outside. This is a dangerous blood loss from the most vulnerable human organs. In the article we will talk about the features of bleeding from parenchymal organs and first aid for them.

Parenchymal organs

All internal organs of a person can be divided into two large groups:

With abdominal everything is very clear - this is the stomach, intestines, bladder. They have a cavity and a wall supplied with vessels. Bleeding from these organs will be associated only with vascular damage. If the vessel is small, then it is able to shrink on its own, narrowing its lumen, the bleeding will stop. But what are parenchymal organs?

They have a completely different structure:

They do not have a cavity, only the main tissue responsible for the function of this organ is the parenchyma. It is permeated with many tiny vessels. If the parenchymal organ is damaged, bleeding develops from each of these capillaries.

An unpleasant feature of the parenchyma and its vessels is the inability to contract, independently stopping the bleeding.

Where are the parenchymal organs located?

Causes

The development of parenchymal blood loss is preceded by a violation of the integrity of the organ. Rupture of the parenchyma and small capillaries become a direct source of hemorrhage.

Causes that can lead to damage to the parenchymal organ:

Injuries;
infections;
malignant tumors;
Vascular tumors are hemangiomas.

Injuries to the abdomen and chest often occur as a result of traffic accidents. Under the impact of a blow to the dashboard, steering wheel or other parts of the car, a rupture of the parenchymal organ occurs. Similar changes occur when the abdominal cavity is injured.

The greatest danger in blunt abdominal trauma is fraught with two-stage ruptures. First, blood accumulates under the capsule of the organ, forming a bruise. At this time, health does not suffer. After a while, the hematoma grows, overstretching of the organ capsule occurs, it breaks and symptoms of internal bleeding develop.

An infection such as tuberculosis often affects the lung tissue. Certain forms of tuberculosis cause destruction of lung tissue. The resulting cavity is called a tuberculous cavity. Bleeding arising from the cavity is manifested by a strong cough with bloody frothy sputum.

Cancer tumors can affect many organs, including parenchymal ones. Growing into the tissue of the organ, the tumor destroys it. At some point, bleeding may occur from the area affected by the tumor.

Predisposes to this a large number of vessels, always penetrating the tumor. Especially large is the bleeding due to hemangioma - a tumor consisting entirely of blood vessels.

Features of blood loss

Rupture of the parenchymal organ is manifested by bleeding from the site of injury. Blood flowing inside the body is not visible externally. Internal parenchymal bleeding develops. Blood is responsible for delivering oxygen and nutrients.

It provides normal immunity, maintains pressure. The loss of even a small amount of blood is manifested by symptoms of anemia.

Acute blood loss in parenchymal bleeding is an emergency. The lack of volume of circulating blood primarily affects the pressure. It decreases as the blood supply to the vessels decreases. All organs suffer from a lack of oxygen. The body tries to the last to maintain nutrition in the most important parts of the body - the brain, kidneys, heart.

The kidneys are among the first to suffer - at low pressure they are not able to perform their function. The kidneys stop filtering urine, its production decreases. With severe blood loss, the kidneys completely stop working, urine is not formed at all.

Suffer from blood loss and all other organs. For the brain, this is manifested by loss of consciousness. For the heart - severe pain and heart rhythm disturbance.

Symptoms

Signs of parenchymal bleeding depend on the amount of blood lost. In total, about 7% of the body weight in the human body is occupied by blood.

Doctors measure the amount of blood lost due to bleeding as a percentage of the total circulating blood volume:

Symptoms of parenchymal bleeding are due to a lack of blood and oxygen starvation of all organs. With severe blood loss, they develop rapidly, within a few minutes. Weak parenchymal bleeding can worsen a person's condition for a day or more.

severe weakness;
Dizziness;
Flashing before the eyes of flashes, black dots;
Loss of consciousness;
Nausea, vomiting;
Pain in the area of the affected organ;
Lack of urine;
Cold sweat;
Paleness of the skin.

When you try to feel the pulse, its weak filling and frequency are determined. Doctors call such a pulse "threadlike", because it is almost not felt. In the absence of pulse waves on the wrist, one should try to determine them on the neck, in the region of the carotid artery.

In a state of severe blood loss, the pulse is preserved only on large arteries like the carotid. But even there it is weak and very frequent.

Mandatory measurement of blood pressure. Values lower than 90/60 mmHg are considered hypotension. Blood loss is always accompanied by low blood pressure.

This is due to the weak filling of blood vessels. The lower the pressure, the more frequent and weak the pulse.

The ratio of heart rate to upper pressure is called the Algover index. Normally, it is 0.5, and with bleeding it increases to one or more. The value of the Algover index indicates the severity of blood loss.

With parenchymal bleeding from the liver, pancreas or spleen, symptoms from the abdomen can be determined. Palpation is determined by pain in the area of the affected organ. In the same place, the abdomen becomes extremely hard. This is due to irritation of the peritoneum by blood pouring into the cavity.

Complications

Severe blood loss is terrible not only in itself. Ultimately, it is complicated by deadly conditions.

These pathologies require emergency surgery along with highly qualified assistance from resuscitators:

hemorrhagic shock;
Syndrome of disseminated intravascular coagulation (DIC).

Hemorrhagic shock develops when 30 percent or more of the blood is lost. It is manifested by loss of consciousness, almost complete absence of a pulse and pressure below 60 mm Hg. Assistance with shock is provided in the intensive care unit with the help of a transfusion of red blood cells, plasma and colloidal solutions.

DIC is a fatal bleeding complication. Blood loss reaches critical values, such that the blood loses its ability to clot. Moreover, it can begin to pour out not only from the injured place, but also from any organs. Mortality in DIC is high even in the intensive care unit.

First aid

If parenchymal bleeding is suspected, the most important thing is to deliver to the clinic. This must be done as quickly as possible. Every minute a person loses more and more blood. With the loss of more than a third of the circulating blood, bleeding becomes critical. Organs develop irreversible changes.

The more time passes since the onset of the hemorrhage, the less likely it is to have a successful outcome.

You can increase your chances of survival by providing first aid correctly:

Apply ice wrapped in a cloth to the area of injury.
The person sits down as comfortably as possible. During transportation, he is disturbed as little as possible.
Do not give any pills, do not feed or offer alcohol.
You can offer a small amount of water or tea.

First steps in parenchymal bleeding

Treatment

After the victim is taken to the emergency department of the clinic, he will be further examined.

Usually these are the most minimal diagnostic procedures that take little time:

Determination of blood group and Rh factor;
Determination of hemoglobin;
Ultrasonography.

Parenchymal bleeding is unable to stop on its own. Almost always, medical care consists of surgical intervention. It is started urgently, with little preoperative preparation.

It usually consists of a transfusion of blood products or solutions to replace lost blood and raise blood pressure.

There are several ways to stop parenchymal hemorrhage:

Using a hemostatic sponge;
Hemming the omentum;
Removal of a part of an organ;
electrical coagulation.

Even an experienced surgeon finds it difficult when the question arises of how to stop parenchymal bleeding. Combinations of methods may be used.

Simultaneously with the operation, hemostatic drugs are prescribed:

They contribute to the formation of blood clots in the smallest vessels of the parenchyma. After the hemorrhage stops, the drugs are canceled. A few more weeks after discharge from the hospital, blood-thinning drugs such as aspirin, warfarin are contraindicated for a person.

Internal bleeding (parenchymal): first aid

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

What organs are called parenchymal?

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

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

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

Causes

What can cause bleeding? Parenchymal hemorrhage may result from:

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

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

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

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

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

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

Parenchymal bleeding. signs

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

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

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

Main symptoms for all types

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

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

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

Help

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

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

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

How is the surgical treatment carried out?

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

There are several ways to stop bleeding.

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

The patient is also given a blood transfusion.

What to do in this case?

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

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

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

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

Conclusion

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

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

What organs are called parenchymal?

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

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

Causes

What can cause bleeding? Parenchymal hemorrhage may result from:

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

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

Parenchymal bleeding. signs

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

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

Main symptoms for all types

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

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

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

Help

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

How is the surgical treatment carried out?

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

There are several ways to stop bleeding.

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

The patient is also given a blood transfusion.

What to do in this case?

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

Conclusion

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

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

Causes

What can cause bleeding? Parenchymal hemorrhage may result from:

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

Parenchymal bleeding. signs

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

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

Main symptoms for all types

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

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

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

Help

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

How is the surgical treatment carried out?

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

There are several ways to stop bleeding.

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

The patient is also given a blood transfusion.

What to do in this case?

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

Conclusion

Signs of parenchymal bleeding and first aid

General characteristics of internal bleeding

Such bleeding occurs when the tissues of the internal organs are injured. Diagnosis of this condition is usually very difficult.

The most common bleeding occurs:

due to mechanical damage;
as a result of neoplasms;
due to severe illness.

What organs can suffer from such a problem

Parenchymal bleeding usually occurs in the following organs:

This type of bleeding can occur:

due to mechanical damage, in which tissue ruptures occurred;
due to diseases of the organs, in particular - due to the appearance of tumors;
due to infectious lesions;
as a result of cancer.

Poor blood clotting can aggravate the situation. Patients who suffer from poor blood clotting are at risk, since hemorrhage can occur not only from mechanical damage, but at any time.

With heavy bleeding, the patient may experience hemorrhagic shock. Rapid blood loss leads to cardiac arrest and death.

State Danger

Parenchymal bleeding is a life-threatening and health-threatening condition. With this phenomenon, blood flows into the surrounding tissue, organ cavity, body cavity.

According to the type of bleeding are divided into the following types:

Clinical manifestations of the disease

Such bleeding, which develops quickly enough, immediately declares itself. However, if the bleeding is slow, then clinical manifestations may be absent or completely invisible.

Symptoms of this condition include:

severe and rapid fatigue;
dizziness;
constant desire to drink;
pallor of the skin;
chills;
pressure drop.

In addition, there are special clinical manifestations that occur depending on the affected organ.

Particular attention should be paid to the following conditions:

The spleen most often ruptures due to mechanical trauma (for example, as a result of an accident). In this case, immediate surgical intervention is required, any delay can cost the patient's life.

The kidneys are susceptible to injury when squeezing or rupturing neoplasms. In this condition, urine is sharply stained, severe pain is observed.

In any case, the condition requires the immediate intervention of specialists. If symptoms of internal bleeding are observed, an ambulance should be called immediately.

First aid and surgery

First of all, you should pay attention to the following manifestations:

the presence of injuries of the abdominal cavity;
mechanical damage to the chest;
the formation of hematomas and bruises;
sharp pain in the area of the damaged organ;
emerging sweat;
chills and fever;
cardiopalmus;
a sharp drop in pressure.

Before the doctors arrive, you must:

Lay the patient down and raise the legs.
Refrigerate the suspected injury site.

When the ambulance arrives, the specialists transport the victim to the hospital and administer to him such medicines as:

Medicines will not be able to stop the bleeding, but they will improve the patient's condition. In order to maintain pressure, specialists will begin to inject a special solution intravenously.

After the patient is taken to the hospital, he will immediately be taken to the operating room, where emergency procedures will be performed.

Before surgery, the following steps will be taken:

If all tests are within the normal range, the doctors will perform an emergency operation. Otherwise, a diagnostic laparoscopy is performed.

There are several ways to stop such a hemorrhage, among them are:

drying with a special sponge;
hemming of the omentum;
amputation of the affected part;
electrocoagulation;
sewing using special seams.

Contacting a medical institution

As soon as the victim is taken to a medical facility, specialists will begin to carry out the following activities:

Examine the patient for blunt or acute trauma.
Check for the development of an infectious disease.
Testing for oncology.
External examination and palpation.
Measurement of such basic parameters as pulse, pressure, temperature.

Especially dangerous options are those when an internal hemorrhage of a mixed type occurs. In this case, the lack of medical care leads to the death of a person.

What is dangerous parenchymal bleeding and ways to stop it

Parenchymal organs

All internal organs of a person can be divided into two large groups:

They have a completely different structure:

An unpleasant feature of the parenchyma and its vessels is the inability to contract, independently stopping the bleeding.

Where are the parenchymal organs located?

Causes

The development of parenchymal blood loss is preceded by a violation of the integrity of the organ. Rupture of the parenchyma and small capillaries become a direct source of hemorrhage.

Causes that can lead to damage to the parenchymal organ:

Injuries;
infections;
malignant tumors;
Vascular tumors are hemangiomas.

Injuries to the abdomen and chest often occur as a result of traffic accidents. Under the impact of a blow to the dashboard, steering wheel or other parts of the car, a rupture of the parenchymal organ occurs. Similar changes occur when the abdominal cavity is injured.

Cancer tumors can affect many organs, including parenchymal ones. Growing into the tissue of the organ, the tumor destroys it. At some point, bleeding may occur from the area affected by the tumor.

Predisposes to this a large number of vessels, always penetrating the tumor. Especially large is the bleeding due to hemangioma - a tumor consisting entirely of blood vessels.

Features of blood loss

It provides normal immunity, maintains pressure. The loss of even a small amount of blood is manifested by symptoms of anemia.

Suffer from blood loss and all other organs. For the brain, this is manifested by loss of consciousness. For the heart - severe pain and heart rhythm disturbance.

Symptoms

Signs of parenchymal bleeding depend on the amount of blood lost. In total, about 7% of the body weight in the human body is occupied by blood.

Doctors measure the amount of blood lost due to bleeding as a percentage of the total circulating blood volume:

severe weakness;
Dizziness;
Flashing before the eyes of flashes, black dots;
Loss of consciousness;
Nausea, vomiting;
Pain in the area of the affected organ;
Lack of urine;
Cold sweat;
Paleness of the skin.

In a state of severe blood loss, the pulse is preserved only on large arteries like the carotid. But even there it is weak and very frequent.

Mandatory measurement of blood pressure. Values lower than 90/60 mmHg are considered hypotension. Blood loss is always accompanied by low blood pressure.

This is due to the weak filling of blood vessels. The lower the pressure, the more frequent and weak the pulse.

Complications

Severe blood loss is terrible not only in itself. Ultimately, it is complicated by deadly conditions.

These pathologies require emergency surgery along with highly qualified assistance from resuscitators:

hemorrhagic shock;
Syndrome of disseminated intravascular coagulation (DIC).

Hemorrhagic shock develops when 30 percent or more of the blood is lost. It is manifested by loss of consciousness, almost complete absence of a pulse and pressure below 60 mm Hg. Assistance with shock is provided in the intensive care unit with the help of a transfusion of red blood cells, plasma and colloidal solutions.

First aid

The more time passes since the onset of the hemorrhage, the less likely it is to have a successful outcome.

You can increase your chances of survival by providing first aid correctly:

Apply ice wrapped in a cloth to the area of injury.
The person sits down as comfortably as possible. During transportation, he is disturbed as little as possible.
Do not give any pills, do not feed or offer alcohol.
You can offer a small amount of water or tea.

First steps in parenchymal bleeding

Treatment

After the victim is taken to the emergency department of the clinic, he will be further examined.

Usually these are the most minimal diagnostic procedures that take little time:

Determination of blood group and Rh factor;
Determination of hemoglobin;
Ultrasonography.

Parenchymal bleeding is unable to stop on its own. Almost always, medical care consists of surgical intervention. It is started urgently, with little preoperative preparation.

It usually consists of a transfusion of blood products or solutions to replace lost blood and raise blood pressure.

There are several ways to stop parenchymal hemorrhage:

Using a hemostatic sponge;
Hemming the omentum;
Removal of a part of an organ;
electrical coagulation.

Even an experienced surgeon finds it difficult when the question arises of how to stop parenchymal bleeding. Combinations of methods may be used.

Simultaneously with the operation, hemostatic drugs are prescribed:

Parenchymal bleeding: signs and first aid

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

Types of bleeding

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

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

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

Internal bleeding

Internal bleeding can also be classified according to the localization of the process. With blows and injuries to the chest, bleeding may occur, in which blood is poured into the pleural cavity. In this case, she, accumulating there, compresses the lungs. Outwardly, this is manifested by difficulty breathing and increasing shortness of breath.

Bleeding in the abdominal cavity can be the result of diseases of the organs located in it, in women it can be an ectopic pregnancy, but most often the cause of internal bleeding in the abdominal cavity is blunt abdominal trauma, which is accompanied by rupture of the liver or spleen. In this case, the bleeding is said to be parenchymal. In addition, with such bleeding, blood can not only pour into the abdominal cavity, but also accumulate in the thickness of the tissues, soaking them.

What is parenchyma

Parenchyma is a tissue that is the basis of many internal organs. Anatomically, it is formed depending on the task of the organ by epithelial, nervous, muscular, myeloid or lymphoid tissue. Parenchymal organs are the liver, spleen, kidneys, various glands and even the brain. A feature of these organs is that in each of them specialized structures are formed by the parenchyma, allowing the organ to perform its functions. In the liver, these are its lobules, in the kidneys - nephrons, in the spleen - follicles. In addition to the parenchyma, in the structure of such organs, a stroma is distinguished - a connective tissue base that performs supporting and trophic functions. When the smallest blood vessels (capillaries) supplying these organs are damaged, parenchymal bleeding occurs. Often, its presence is difficult to diagnose and therefore, by the time care begins, there may be a large amount of blood loss. That is why timely diagnosis and stopping of parenchymal bleeding is a priority for the surgeon.

Causes of parenchymal bleeding

The first place among the causes unconditionally occupies trauma. Regardless of what caused it - a traffic accident, a blow or a fall from a height - even a slight impact can be enough to start parenchymal bleeding. This is due to the fact that even a small tear of the organ capsule (and it, as a rule, is very tender) is enough, as the blood vessels that feed the parenchyma and therefore are present in large numbers here, are damaged and blood begins to pour into the body cavity.

The result of bleeding in the body can be a hemorrhage (in this case, the outflowing blood impregnates the surrounding tissues) or a hematoma. Then a cavity filled with blood is formed in the tissue. With parenchymal bleeding, both of these options are possible. The danger lies in the fact that the vessels that feed the parenchyma do not collapse in their structure, which means that the bleeding will continue. Even if it is not intense, the symptoms of anemia will still increase, as a result, the organs and the brain will suffer from hypoxia. With significant blood loss, hemorrhagic shock develops - a serious condition in which blood pressure decreases significantly and signs of multiple organ failure progress.

Signs of parenchymal bleeding

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

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

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

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

Life-threatening bleeding

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

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

Parenchymal bleeding - first aid

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

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

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

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

Treatment

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

There are several ways to stop parenchymal bleeding. This:

organ resection;
drying of the stuffing box;
electrocoagulation of blood vessels;
suturing of blood vessels;
embolization of the feeding vessel;
use of hemostatic sponges.

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Parenchymal organs

All internal organs of a person can be divided into two large groups:

cavity;
Parenchymal.

With abdominal everything is very clear - this is the stomach, intestines, bladder. They have a cavity and a wall supplied with vessels. Bleeding from these organs will be associated only with vascular damage. If the vessel is small, then it is able to shrink on its own, narrowing its lumen, the bleeding will stop. But what are parenchymal organs?

They have a completely different structure:

Liver;
Lungs;
Pancreas;
kidneys;
Spleen.

They do not have a cavity, only the main tissue responsible for the function of this organ is the parenchyma.. It is permeated with many tiny vessels. If the parenchymal organ is damaged, bleeding develops from each of these capillaries.

An unpleasant feature of the parenchyma and its vessels is the inability to contract, independently stopping the bleeding.

Where are parenchymal organs located?

Causes

The development of parenchymal blood loss is preceded by a violation of the integrity of the organ. Rupture of the parenchyma and small capillaries become a direct source of hemorrhage.

Causes that can lead to damage to the parenchymal organ:

Injuries;
infections;
malignant tumors;
Vascular tumors are hemangiomas.

The greatest danger in blunt abdominal trauma is fraught with two-stage ruptures. First, blood accumulates under the capsule of the organ, forming a bruise. At this time, health does not suffer. After a while, the hematoma grows, overstretching of the organ capsule occurs, it breaks and symptoms of internal bleeding develop.

An infection such as tuberculosis often affects the lung tissue. Certain forms of tuberculosis cause destruction of lung tissue. The resulting cavity is called a tuberculous cavity. Bleeding arising from the cavity is manifested by a strong cough with bloody frothy sputum.

Cancer tumors can affect many organs, including parenchymal ones. Growing into the tissue of the organ, the tumor destroys it. At some point, bleeding may occur from the area affected by the tumor.

Predisposes to this a large number of vessels, always penetrating the tumor. Especially large is the bleeding due to hemangioma - a tumor consisting entirely of blood vessels.

Features of blood loss

Rupture of the parenchymal organ is manifested by bleeding from the site of injury. Blood flowing inside the body is not visible externally. Internal parenchymal bleeding develops. Blood is responsible for delivering oxygen and nutrients.

It provides normal immunity, maintains pressure. The loss of even a small amount of blood is manifested by symptoms of anemia.

Acute blood loss in parenchymal bleeding is an emergency. The lack of volume of circulating blood primarily affects the pressure. It decreases as the blood supply to the vessels decreases. All organs suffer from a lack of oxygen. The body tries to the last to maintain nutrition in the most important parts of the body - the brain, kidneys, heart.

The kidneys are among the first to suffer - at low pressure they are not able to perform their function. The kidneys stop filtering urine, its production decreases. With severe blood loss, the kidneys completely stop working, urine is not formed at all.

Suffer from blood loss and all other organs. For the brain, this is manifested by loss of consciousness. For the heart - severe pain and heart rhythm disturbance.

Symptoms

Signs of parenchymal bleeding depend on the amount of blood lost. In total, about 7% of the body weight in the human body is occupied by blood.

Doctors measure the amount of blood lost due to bleeding as a percentage of the total circulating blood volume:

To 10%- light bleeding;
10-20% - moderate bleeding;
21-30% - heavy bleeding;
Over 30%- massive, critical blood loss.

Symptoms of parenchymal bleeding are due to a lack of blood and oxygen starvation of all organs. With severe blood loss, they develop rapidly, within a few minutes. Weak parenchymal bleeding can worsen a person's condition for a day or more.

The victim is concerned about:

severe weakness;
Dizziness;
Flashing before the eyes of flashes, black dots;
Loss of consciousness;
Nausea, vomiting;
Pain in the area of the affected organ;
Lack of urine;
Cold sweat;
Paleness of the skin.

In a state of severe blood loss, the pulse is preserved only on large arteries like the carotid. But even there it is weak and very frequent.

Mandatory measurement of blood pressure. Values lower than 90/60 mmHg are considered hypotension. Blood loss is always accompanied by low blood pressure.

This is due to the weak filling of blood vessels. The lower the pressure, the more frequent and weak the pulse.

The ratio of heart rate to upper pressure is called the Algover index. Normally, it is 0.5, and with bleeding it increases to one or more. The value of the Algover index indicates the severity of blood loss.

With parenchymal bleeding from the liver, pancreas or spleen, symptoms from the abdomen can be determined. Palpation is determined by pain in the area of the affected organ. In the same place, the abdomen becomes extremely hard. This is due to irritation of the peritoneum by blood pouring into the cavity.

Complications

Severe blood loss is terrible not only in itself. Ultimately, it is complicated by deadly conditions.

These pathologies require emergency surgery along with highly qualified assistance from resuscitators:

hemorrhagic shock;
Syndrome of disseminated intravascular coagulation (DIC).

Hemorrhagic shock develops when 30 percent or more of the blood is lost. It is manifested by loss of consciousness, almost complete absence of a pulse and pressure below 60 mm Hg. Assistance with shock is provided in the intensive care unit with the help of a transfusion of red blood cells, plasma and colloidal solutions.

DIC is a fatal bleeding complication. Blood loss reaches critical values, such that the blood loses its ability to clot. Moreover, it can begin to pour out not only from the injured place, but also from any organs. Mortality in DIC is high even in the intensive care unit.

First aid

If parenchymal bleeding is suspected, the most important thing is to deliver to the clinic. This must be done as quickly as possible. Every minute a person loses more and more blood. With the loss of more than a third of the circulating blood, bleeding becomes critical. Organs develop irreversible changes.

The more time passes since the onset of the hemorrhage, the less likely it is to have a successful outcome.

You can increase your chances of survival by providing first aid correctly:

Apply ice wrapped in a cloth to the area of injury.
The person sits down as comfortably as possible. During transportation, he is disturbed as little as possible.
Do not give any pills, do not feed or offer alcohol.
You can offer a small amount of water or tea.

After the victim is taken to the emergency department of the clinic, he will be further examined.

Usually these are the most minimal diagnostic procedures that take little time:

Parenchymal bleeding is unable to stop on its own. Almost always, medical care consists of surgical intervention. It is started urgently, with little preoperative preparation.

It usually consists of a transfusion of blood products or solutions to replace lost blood and raise blood pressure.

There are several ways to stop parenchymal hemorrhage:

Even an experienced surgeon finds it difficult when the question arises of how to stop parenchymal bleeding. Combinations of methods may be used.

Simultaneously with the operation, hemostatic drugs are prescribed:

Vikasol;
Etamzilat;
Aminocaproic acid.

They contribute to the formation of blood clots in the smallest vessels of the parenchyma. After the hemorrhage stops, the drugs are canceled. A few more weeks after discharge from the hospital, blood-thinning drugs such as aspirin, warfarin are contraindicated for a person.