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Hematoma

Synonyms: haematoma
German: Hämatom

1 Definition

A hematoma is an accumulation of blood that passed from blood vessels to extravasal tissue or into an existing cavity.

2 Causes

Hematomas are caused by damage to the tissue of blood vessels which can be a result of trauma, degenerative processes, or tumors. The disintegration of blood vessels leads to diffuse bleeding to the surrounding tissue. Hematomas preferably spread along anatomical crevices that represent the path of least resistance for the blood.

3 Classification

Hematomas are classified depending on their locations. Examples are:

3.1 Cranium/CNS

3.2 Abdominal area

3.3 Bones

3.4 Eye

3.5 Skin and skin appendages

3.6 Muscle

3.7 Reproductive organs

4 Clinical significance

Superficial hematomas in the subcutaneous tissue are easy to identify due to the discoloration of the affected tissue section. Hematomas that are situated more deeply either cause swelling or can only be diagnosed indirectly based on the resulting loss of function, as is the case with intracranial hematomas.

5 Therapy

Therapy depends on location and severity of the hematoma. Clearly circumscribed subcutaneous hematomas heal by themselves and are treated conservatively with heparin gels and by cooling the affected area. More expansive, deeply situated hematomas often require incision and drainage or surgical revision to avoid complications.

Intracranial hematomas, however constitute an emergency that immediately has to be resolved because accumulating blood displaces or compresses healthy brain tissue. The same applies to hematomas in other closed anatomical spaces, e.g. the compartment syndrome.

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