Internal Bleeding
Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editor: Melissa Conrad Stöppler, MD
What is internal bleeding?
While the general public understands that internal
bleeding means bleeding that can't be seen on the outside of the body, medical
personnel tend to use terms that describe precisely where inside the body the
bleeding is found. The internal bleeding may occur within tissues, organs, or in
cavities of the body including the head, chest, and abdomen. Examples of other
potential sites of bleeding include the eye, lining tissues of the heart, muscles, and joints.
Bleeding outside the body is quite easy to recognize. If the skin is damaged by
a laceration,
puncture, or abrasion, blood can
be witnessed as it streams out of the body. The scalp, with its rich blood
supply, is notorious for demonstrating massive blood loss. Internal bleeding can
be much more difficult to identify. It may not be evident for many hours after
it begins, and symptoms occur when there is significant blood loss or if a
blood
clot is large enough to compress an organ and prevent it from functioning properly.
Internal bleeding occurs when damage to an artery or vein allows blood to
escape the circulatory system and collect inside the body. The amount of
bleeding depends upon the amount of damage to an organ and the blood vessels
that supply it, as well as the body's ability to repair breaks in the walls of
the blood vessels. The repair mechanisms available include both the blood
clotting system and the ability of blood vessels to go into spasm to decrease
blood flow to an injured area.
Patients who take anti-clotting medication such as
warfarin (Coumadin), clopidogrel (Plavix), heparin, or aspirin are more prone to bleeding than people
who do not take these medications. These individuals may experience significant bleeding even with relatively minor injury or illness,
and the risk of bleeding needs to be balanced against the benefits of taking the
medication.
Some people have genetic or inborn
errors of the blood clotting system. Minor injuries may cause major bleeding in
these cases. Hemophilia and
von Willebrand
disease are two examples.
Next: What causes internal bleeding? »
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