-IBIS-1.5.0-
tx
cutaneous system
contusion/hematoma
diagnoses

definition and etiology

definition:
localized collection of extravasated blood, usually clotted, in an tissue, space, or organ; also a bruise

etiology:
usually from trauma inducing a break in a vessel wall and allowing blood to escape into surrounding tissues

signs and symptoms

signs and symptoms:
• skin: localized swelling, discoloration (from red to blue to green or yellow) with failure to blanch, and tenderness; history of recent trauma to area
• deep tissues: history of recent trauma; depending on extent of injury, may include pain, swelling, or rigidity
• brain: may show signs and symptoms of neural dysfunction from increased pressure on various structures in the brain; headaches are an early sign

course and prognosis

The typical ecchymosis begins as a deep blue/purple and changes to brown and yellow as the RBCs are broken down and the clot removed. The usual healing time is about 7-10 days depending on the extent of the injury. In children on whom multiple contusions appear in various stages of healing, child abuse must be ruled out. A hematoma over a joint injury may make it hard to determine the degree of injury. If injury to the torso or head has occurred, organ or cranial hematomas must be ruled out. Cranial hematomas are especially serious, as the patient may feel fine at the time of the accident, but then slowly develop symptoms indicating a serious condition.

differential diagnosis

• porphyrias
• bleeding dyscrasias
• purpuras
• child abuse
• vitamin C deficiency (associated with petechiae)


footnotes