Hemmorage

Hemorrhage
Diagram of a blood vessel
Synonyms	Bleeding
Pronounce	N/A
Specialty	N/A
Symptoms	N/A
Complications	Hypovolemic shock, Anemia, Organ failure
Onset	Sudden or gradual
Duration	Variable
Types	N/A
Causes	Trauma, Surgery, Coagulation disorders, Aneurysm rupture
Risks	Hypertension, Anticoagulant therapy, Hemophilia
Diagnosis	N/A
Differential diagnosis	N/A
Prevention	N/A
Treatment	Direct pressure, Surgery, Transfusion
Medication	N/A
Prognosis	Depends on severity and location
Frequency	Common
Deaths	N/A

Hemorrhage, also known as bleeding, is the loss of blood from the circulatory system. It can occur internally, where blood leaks from blood vessels inside the body, or externally, through a natural opening such as the mouth, nose, ear, urethra, vagina, or anus, or through a break in the skin.

Classification

Hemorrhages can be classified based on their location, cause, and severity:

By Location

• Internal Hemorrhage: Occurs inside the body and may not be immediately visible. Examples include:

 * Intracranial hemorrhage
 * Gastrointestinal bleeding
 * Hemothorax

• External Hemorrhage: Blood loss that is visible outside the body. Examples include:

 * Epistaxis (nosebleed)
 * Hematemesis (vomiting blood)
 * Hematochezia (blood in stool)

By Cause

• Traumatic Hemorrhage: Resulting from physical injury.
• Non-traumatic Hemorrhage: Due to medical conditions such as:

 * Aneurysm rupture
 * Peptic ulcer
 * Coagulation disorders

By Severity

• Minor Hemorrhage: Small blood loss, often self-limiting.
• Major Hemorrhage: Significant blood loss requiring medical intervention.
• Massive Hemorrhage: Life-threatening blood loss, often leading to shock.

Pathophysiology

Hemorrhage occurs when the integrity of a blood vessel is compromised, leading to blood escaping from the circulatory system. This can result from:

• Vascular injury
• Platelet dysfunction
• Coagulation factor deficiency

The body responds to hemorrhage by activating the coagulation cascade to form a clot and stop the bleeding. However, in cases of severe hemorrhage, the body's compensatory mechanisms may be overwhelmed, leading to hypovolemic shock.

Diagnosis

Diagnosis of hemorrhage involves:

• Clinical assessment: Checking for signs of bleeding, such as bruising, swelling, or visible blood.
• Imaging studies: CT scan, MRI, or ultrasound to identify internal bleeding.
• Laboratory tests: Complete blood count (CBC), coagulation profile, and blood typing.

Management

The management of hemorrhage depends on the location, cause, and severity:

• Initial Management:

 * Apply direct pressure to external bleeding sites.
 * Elevate the affected area if possible.
 * Administer oxygen and fluids to maintain circulation.

• Definitive Treatment:

 * Surgical intervention to repair damaged vessels.
 * Blood transfusion to replace lost blood.
 * Medications to promote clotting, such as tranexamic acid.

Prognosis

The prognosis of hemorrhage varies widely depending on the cause, location, and promptness of treatment. Early intervention can significantly improve outcomes.

Prevention

Preventive measures include:

• Managing risk factors such as hypertension and anticoagulant therapy.
• Regular monitoring for individuals with known bleeding disorders.

Also see

• Coagulation disorders
• Hypovolemic shock
• Blood transfusion
• Trauma surgery