• Skip to main content
  • Skip to primary sidebar
  • Health
  • Presentation
  • Procedures
  • Diseases
  • Women
  • Subscribe
  • About
    • Privacy Policy
    • Contact Us

medcaretips.com

Health, Medicine and Medical Care

telegram channel medcaretips
You are here: Home / Presentation / Hemorrhage or Bleeding – Causes and Types

Hemorrhage or Bleeding – Causes and Types

By Dr Arun Pal Singh

toc
    • Types of Hemorrhage
    • Causes of Hemorrhage
    • Management of Hemorrhage

Hemorrhage or bleeding refers to blood escaping from the circulatory system. A hemorrhage may be external and visible on the outside of the body or internal, where there is no sign of bleeding outside the body.

Bleeding can occur in almost any area of the body.

Internal bleeding occurs when there is a damaged vessel or organ.

External bleeding is generally through a break in the skin. It can also occur when internal bleeding exits through a natural orifice such as mouth, nose, anus, vagina.

Hemorrhage in stomach cancer visualized by endoscope, Image from Wikipedia, in public domain

Types of Hemorrhage

It is done by World Health Organization Scale

Grade 0

No bleeding

Grade 1

Petechial bleeding

Grade 2

Mild but clinically significant

Grade 4

Sever bleeding requiring transfusion

Grade 5

Severe associated with fatality

Depending on Bleeding vessels

Arterial

Arterial hemorrhage is recognized as bright red blood, spurting as a jet which rises and falls in time with the pulse. In protracted bleeding, and when quantities of intravenous fluids other than blood are given, it can become watery in appearance.

Venous

Venous hemorrhage is a darker red, a steady and copious flow. Blood loss is particularly rapid when large veins are opened.

It must be noted that pulmonary artery hemorrhage is dark red (venous blood) whereas bleeding from the pulmonary veins is bright red (oxygenated).

Capillary

Capillary hemorrhage is a bright red, often rapid, ooze.

Bleeding after Surgery

Primary hemorrhage

It occurs at the time of injury or operation.

Reactionary hemorrhage

Reactionary hemorrhage may follow primary hemorrhage within 24 hours (usually 4—6 hours) and is mainly due to rolling (‘slipping’) of a ligature, dislodgement of a clot or cessation of reflex vasospasm.

Secondary hemorrhage

Secondary hemorrhage occurs after 7—14 days, and is due to infection and sloughing. The pressure of a drainage tube, a fragment of bone, a ligature in an infected area or cancer.

Depending on their Presentation

  • Hematemesis – vomiting fresh blood
  • Hemoptysis – coughing up blood from the lungs
  • Hematochezia – Loss of fresh blood through the rectum
  • Melena – loss of blood through feces
  • Hematuria – Blood in the urine from urinary bleeding

Causes of Hemorrhage

The hemorrhage occurs due to either trauma, a medical condition or combination. Some drugs may affect the coagulation pathway and cause bleeding.

Traumatic bleeding

Trauma is an important cause of hemorrhage and can lead to bleeding anywhere in the body.

Common types of traumatic are

  • Abrasions or grazes
  • Hematoma or bruises
  • Lacerations
  • Puncture wounds or animal bites
  • Crushing injuries
  • Gunshot injuries
  • Fractures

Medical Conditions

There is a large number of medical conditions that may lead to bleeding including the following.

  • Hemophilia
  • Leukemia
  • Liver disease
  • Menstrual bleeding
  • Coagulation Disorders
    • Thrombocytopenia, low blood platelet count
    • von Willebrand disease
    • Vitamin K deficiency
  • Bowel obstruction
  • Congestive heart failure (CHF)
  • Tumors
  • Acute bronchitis
  • Endometriosis
  • Aneurysm

Drugs

Some drugs like NSAID, warfarin,  and heparin can also affect these mechanisms.

Management of Hemorrhage

Visible blood is the most obvious sign in external hemorrhage. Internal bleeding, on the other hand, may go unnoticed unless it is substantial or affect a vital area causing symptoms.

Internal bleeding may be completely asymptomatic or cause symptoms depending on the region. Pulmonary bleeding may present as hemoptysis or hemothorax.

GI bleeding may cause hematemesis, melena or bleeding per rectum.

Bleeding in urine may be a sign of urinary infection.

Bleeding in the brain may present with a neural deficit.

Minor bleeding wounds require wound cleaning and dressings.

In case of substantial bleed, the further loss is minimized by pressure and packing, position, and rest.
The definite treatment of external bleeding depends on the site and size of the wound but may include operative procedures as needed like ligation, repair, and excision. Fluid replacement and blood transfusion are carried as per needs.

The elevation of limbs employs gravity to reduce bleeding. Elevation also causes helpful vasoconstriction.

Internal bleeding requires different management protocols depending on the site and its effects.

 

Spread the Knowledge
3     
3
Shares
3    

Filed Under: Presentation

Primary Sidebar

Subscribe to updates

Receive articles in your inbox !!
Enter your email address below

nash or nonalcoholic steatohepatitis

NASH or Nonalcoholic steatohepatitis

Nonalcoholic steatohepatitis (NASH) is inflammation and damage of the … [Read More...] about NASH or Nonalcoholic steatohepatitis

Autoimmune hepatitis

Autoimmune Hepatitis: Clinical features, Diagnosis And Treatment

Autoimmune hepatitis is a disease in which the immune system of the … [Read More...] about Autoimmune Hepatitis: Clinical features, Diagnosis And Treatment

Pruritus or Itching

Itching or Pruritus : Causes, Diagnosis, and Treatment

Itching is an unpleasant sensation of the skin that leads to a desire … [Read More...] about Itching or Pruritus : Causes, Diagnosis, and Treatment

Pain

Pain-Classification, Diagnosis and Treatment

Pain is an unpleasant and uncomfortable sensation caused by injury or … [Read More...] about Pain-Classification, Diagnosis and Treatment

acne care-dos and don'ts

10 Dos and Don’ts About Acne Care

Acne (pimples) is a common, self-limiting skin condition that affects … [Read More...] about 10 Dos and Don’ts About Acne Care

Copyright © 2023 Med Care Tips

Manage Cookie Consent
This website uses cookies. Please accept cookies for a better visiting experience
Functional Always active
The technical storage or access is strictly necessary for the legitimate purpose of enabling the use of a specific service explicitly requested by the subscriber or user, or for the sole purpose of carrying out the transmission of a communication over an electronic communications network.
Preferences
The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user.
Statistics
The technical storage or access that is used exclusively for statistical purposes. The technical storage or access that is used exclusively for anonymous statistical purposes. Without a subpoena, voluntary compliance on the part of your Internet Service Provider, or additional records from a third party, information stored or retrieved for this purpose alone cannot usually be used to identify you.
Marketing
The technical storage or access is required to create user profiles to send advertising, or to track the user on a website or across several websites for similar marketing purposes.
Manage options Manage services Manage vendors Read more about these purposes
View preferences
{title} {title} {title}