Internal Bleeding: Symptoms, Causes, Treatment

Internal bleeding has a very difficult definition. It occurs when there is bleeding inside your body that you can not see. It is often only controlled by surgery. Patients suffering from internal bleeding need to be rushed to the operating room rather quickly, depending on the severity of the bleeding.

Extent Of The Severity Of An Internal Bleeding


You must rely on the signs and symptoms to determine the extent of the severity of an internal hemorrhage. The extent of the severity is often determined by the type of wound you have got and the type of blood vessels that are actually injured. For instance, capillary bleeds slower compared to a vein.

Internal Bleeding Symptoms&Signs

An example would be a severely crushed leg. You are not expecting a lot of bleeding but you know that you are having a lot of internal bleeding due to damage to the arteries within that leg and it can only be stopped by the use of tourniquets. 

As a result of external trauma, the internal hemorrhage may appear in the same areas of the body. If somebody has a gunshot wound to the abdomen, they will have both external and internal hemorrhage. But if they have blunt force trauma to the abdomen, it can result in only internal hemorrhage. 

The significance of finding the symptoms:

Males contain approximately 70 milliliters of blood per kilogram of body weight, whereas females contain only 65 milliliters per kilogram. The body can not tolerate an acute blood loss of more than 20%, so when a typical adult loses more than one liter of blood, their vital signs change significantly. This is also applicable in the cases of infants and children, but a little bit differently. They may have the same effects but with smaller amounts of blood loss. The compensation depends on how rapidly a person bleeds. When somebody is bleeding out quickly, their compensatory mechanisms may not have enough time to maintain perfusion. This is why it is very important to find out as many additional symptoms as possible in order to properly diagnose and address the internal hemorrhage.

Primary symptoms :

There are mainly two kinds of primary symptoms of internal bleeding.

Traumatic internal bleeding: This occurs from an external hemorrhage or injury, usually in that same area as the external trauma. Psychological problems can also be considered as trauma in some cases. For example, chronic depression sometimes results in a brain aneurysm.

Nontraumatic internal bleeding: A nontraumatic internal hemorrhage usually occurs in the cases of:

  • Gastrointestinal bleed 
  • Ruptured ectopic pregnancy
  • Ruptured aneurysms 

These are very lethal conditions and must be treated promptly. 

Secondary symptoms :

Primary symptoms of internal bleeding do not always develop quickly, so other signs and symptoms are needed to make the diagnosis. 

Pay close attention –

  1. If there is a complaint about pain or tenderness. 
  2. If there is a development of tachycardia, which is a compensatory mechanism.
  3. If the patient has pallor which means that there is shunting blood.
  4. If the sympathetic nervous system is kicked up. This is also a compensatory mechanism. When it happens, be alert to the development of shock as well.

The severity of the symptoms :

Consider internal hemorrhage to be serious if any of the following is present – 

  • When there is a significant mechanism of injury. 
  • If there is a poor general appearance. Consider your way of breathing, the circulation of blood flow throughout your body and your mental status as general parameters. 
  • If there are signs and symptoms of shock.
  • Significant amount of blood loss. If there is a rapid blood loss or if there is uncontrolled bleeding that you cannot get to stop, all of those would be cause for serious concern. 
  • If there is a blood clot. Venous and capillary bleeding are more likely to clot spontaneously than an arterial bleed as arterial bleeds are typically under high pressure.

Things to remember :

Bleeding from an open artery is bright red, it tends to spurt in time with the pulse, is difficult to control, and may require a tourniquet. Blood from an open vein is a darker type of blood and it flows steadily. It is easier to manage. A damaged capillary vessel typically just oozes steadily but slowly, it is not generally an emergent type of bleeding.

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