home Analyzes Hemorrhagic diseases symptoms and signs. Hemorrhages - what is it? Types, causes and treatment. Subcutaneous hemorrhages. Bruise after injection

Hemorrhagic diseases symptoms and signs. Hemorrhages - what is it? Types, causes and treatment. Subcutaneous hemorrhages. Bruise after injection

The consequences of hemorrhage depend on its severity. Sometimes this does not lead to serious consequences, but sometimes it can cause anemia and even lead to death. If blood accumulates inside body tissues, it causes compression internal organs, which impairs their functionality. Since bleeding itself is a consequence of the disease, the cause itself must be treated. Accordingly, for such a phenomenon as hemorrhage, treatment will need to be prescribed by a specialist after a thorough examination.

Hemorrhages at the injection site

Hemorrhages at the injection site appear after certain drugs or as a result of hemorrhagic diseases. There is a method by which the permeability of the vessel wall can be determined: 1-2 ml of saline solution is injected into the skin, after which the manifestation of hemorrhages is observed. This method was called Hess's symptom (British scientist, 19th century).

Hemorrhages on the skin

Hemorrhages on the skin appear due to hemorrhages when blood enters the dermal tissue. Such hemorrhages can be of the following types:

Subcutaneous hematomas: hemorrhages in the tissue under the upper layer of the dermis. The resulting voids under the skin are filled with clotted blood. At the site of the hematoma, a swelling forms, changing color over time from bright red-blue to yellow-green;

Ecchymoses (bruises): have different sizes and appear due to subcutaneous hemorrhages;

Petechiae: capillary hemorrhages on the skin. These pinpoint hemorrhages range in size from a dot left by a gel pen to the size of a kidney bean.

Hemorrhages in the stomach

Bleeding in the stomach may be a consequence of hemorrhagic erosive gastritis. However, hemorrhages in the stomach are not the only symptom of the disease. The patient may experience erosive and inflammatory changes in the mucous membrane and high gastric secretion. Sometimes bleeding can be caused by the high permeability of the walls of the gastric vessels, as well as a high degree of susceptibility to damage.

Expulsive hemorrhage

Expulsive hemorrhage - severe postoperative complication on eyeball represents bleeding from the ciliary arteries. Bleeding may begin during surgery. However, most often, rupture of the ciliary arteries occurs after surgery due to severe vasodilation due to reactive hypertension. It is observed in patients suffering from atherosclerosis, hypertension, and eye hypertension. Before surgery, these factors must be taken into account by doctors. Sometimes such bleeding can cause the choroid and retina to be pushed out through the surgical wound, leading to loss of vision. Therefore, expulsive hemorrhage requires urgent surgical intervention: posterior trepanation of the sclera, application of scleral sutures.

Intramucosal hemorrhages

Intramucosal hemorrhages are a tendency for blood vessels in the mucous membrane to bleed due to injury or disease. This syndrome can be acquired or congenital. In addition, this tendency can be inherited. Their main cause is considered to be a violation of one or more links of hemostasis.

Among the hereditary causes of hemorrhage, it is worth highlighting the most common diseases: hemophilia types A, B, von Willebrand disease, thrombocytopathy. The causes of acquired mucosal hemorrhagic syndrome can be: DIC syndrome, hemorrhagic vasculitis, thrombocytopenia, thrombocytopathy and deficiency of prothrombin complex factors.

Hemorrhages - what is it? Types, causes and treatment. Subcutaneous hemorrhages. Bruise after injection

Hemorrhages are hemorrhages in various parts of the body, varying in severity. The causes of their occurrence include internal and external pathologies of the body. Often, hemorrhages are manifested by the accumulation of blood in the tissues, but sometimes the blood comes out.

Causes of hemorrhages

Essentially these are complications after injections, but this is not always the case.

Very often, the cause of bleeding lies in the high permeability of the vascular walls or their disruption. The integrity of the vessel is compromised when a mechanical injury occurs. The reasons for blood leaking through the vessel wall are as follows: dermatological diseases, for example, chronic dermatosis or psoriasis; acquired pathologies of the circulatory system (DIC syndrome, hemorrhagic vasculitis or bleeding disorder, thrombocytopathy); congenital genetic pathology, for example, hemophilia. Hemorrhages of almost all types are closely associated with taking hormonal medications, depression or psychological stress.

Hemorrhages are hemorrhages that are divided into the following types depending on the reasons for their occurrence:

bleeding caused by violations of the integrity of the walls of a blood vessel due to exposure to an infection or a chemical substance;
bleeding resulting from a decrease in the thickness of the walls of blood vessels;
bleeding resulting from mechanical damage to blood vessels. This is how a bruise appears after an injection.

Depending on the location, types of hemorrhage can be:

capillary (bleeding from small vessels);
internal (hemorrhages into tissues and organs);
venous (bleeding from damaged veins);
external;
arterial (intense bleeding from the arteries);
parenchymal (bleeding of tissues that form organs).

Main symptoms of internal bleeding

How hemorrhages manifest depends on the location and type of bleeding. Although external bleeding is detected quite easily, internal bleeding is very often not felt. Internal bleeding can be detected by several specific symptoms, for example:

This is how damage to large vessels manifests itself.

These symptoms are common for internal bleeding, but there is also a list of signs that are characteristic of different types of hemorrhages.

Hemorrhages at the injection site. What is this?

Often, complications may occur during therapy after injection. Hemorrhages that occur after intramuscular injection are called local bleeding, which occurs due to tissue damage.

Usually, over time, the blood stain goes away on its own, but sometimes a specialist can prescribe water-soluble medications. Intravenous injections may cause bleeding when a vessel is punctured through and may not be as pronounced as with intramuscular injections.

Causes of skin hemorrhages

Hemorrhages are a pathology that occurs on the skin due to blood leaking into the skin tissue through the walls of blood vessels or hemorrhage. They look like blood spots on the skin. Throughout time, hemorrhages tend to change color, starting from bright red and ending with greenish-yellow. There is no special treatment in such cases; these spots resolve on their own over time. Especially complications after injections.

Skin hemorrhages also include hematomas.

Subcutaneous hematomas form under the skin layer and are more like bruises. They can be formed as a result of various diseases (lupus erythematosus, scarlet fever, syphilis, tuberculosis) or injuries. Patients with hemophilia often suffer from such hematomas. Spots on the skin of such people arise from any damage to blood vessels. There are three degrees of subcutaneous hematomas.

Signs of a mild hematoma appear gradually, approximately after a day after the injury, and at the same time it does not in any way affect the functioning of the organ on which it formed. If painful sensations and there are, then weakly expressed. And also, if the resulting hematoma is not complicated, it will go away on its own without treatment. The formation of a moderate hematoma occurs after three to four hours, and such a hematoma can partially disrupt the functioning of the organ on which it appeared.

Around such hematomas, soft tissue edema and slight swelling form. Apply cold and a pressure bandage to the hematoma, and then seek help from a doctor. Serious injury can cause the formation of a severe hematoma, which will disrupt the functioning of organs. Hemorrhage forms quite quickly, within an hour it will be possible to notice the appearance blue spot. Mostly visible to the naked eye subcutaneous hematoma. After some time, such a hematoma may intensify and develop into an intramuscular one, and then the patient will experience pain in the muscles and numbness. With this type of hematoma, you should definitely consult a doctor to prescribe subsequent treatment. If left untreated, a severe hematoma can seriously harm the human body. And just a bruise after an injection is quite unpleasant.

What is the danger of hemorrhage?

The severity of such an insidious phenomenon as hemorrhage depends directly on the area of damage and how intense the bleeding is. Despite the fact that usually such small injuries resolve on their own, exceptions occur, which are characterized by suppuration of the hemorrhage site and the need for surgical intervention. In some cases, hemorrhages lead to tissue destruction, which also leads to severe consequences. In such cases, hemorrhages in the heart, brain and lungs are considered the most dangerous. Eye hemorrhages also occur.

Which specialist should I contact?

No matter how complex the nature of hemorrhage may be, it is very important to determine the cause of its occurrence as quickly as possible. A local therapist and highly specialized doctors, such as an infectious disease specialist, hematologist, dermatologist or endocrinologist, will help resolve this problem.

Carrying out diagnostics

After the examination, the specialist can put primary diagnosis, but it will still be necessary to take a coagulogram (a general blood test to test it for clotting) for an accurate diagnosis. In some cases, it is possible to prescribe a bacteriological blood test, on the basis of which the issue of therapy will be decided.

First aid for bleeding

Previously, it was found that hemorrhages are bleeding from blood vessels due to their damage. Therefore, the first thing a person can do in case of mild hemorrhage is to apply cold to the injured area, which will reduce the intensity of bleeding. Follow-up care should be tailored to the type of hemorrhage. Venous bleeding is quite easily determined by the color of the blood, which will be burgundy or bright red, and by its continuous but slow flow. With such an injury, in order to carry out first aid, you need to apply a tourniquet below the wound and a tight bandage. A mandatory point is the time stamp when the tourniquet was applied. For a small wound, wrap it with a bandage, since venous vessels may self-retract and fall off.

Arterial bleeding

Arterial bleeding differs from venous bleeding in that bright red blood will flow from the wound like a fountain. In this case, you need to immediately apply a tourniquet, because if the bleeding is not stopped, the person may die. In this case, a tourniquet is applied above the nasm wound, and a bandage is applied to it. The tourniquet is left for one to two hours, and after this time it needs to be slightly lowered for about 5 minutes so that blood circulates through the limb, otherwise toxins will accumulate in the stagnant blood, and after removing the tourniquet the person may die from shock.

If we talk about such a phenomenon as subcutaneous hemorrhages, then they do not pose a serious danger if such bleeding does not occur in a person with poor clotting. Then you need to bandage and treat the wound. Such bleeding can be stopped using modern hemostatic agents such as Hemostop and Celox. The powder granules help clot the blood, creating a jelly-like appearance, but this type of wound can be difficult to treat. Internal bleeding is one of the most severe ones, in which case it is necessary to consult a doctor. At the scene of the incident, you can only apply ice to the victim and immediately send him to the hospital or call an ambulance. Until the doctors arrive, the patient should be at rest and practically motionless.

How to get rid of hemorrhages?

Hemorrhages are treated after a thorough examination. When prescribing treatment and making a diagnosis, the doctor needs to take into account that some forms of hemorrhages lead to the development of complications. This is the reason why it is necessary to consult a doctor at every stage of treatment. If complications occur, inflammatory processes can begin, which can sometimes lead to death. It is necessary to accurately determine the patient’s condition, the clinical form of hemorrhage and the tendency to complications in order to carry out the correct treatment. For example, minor injuries do not require medication. But if skin hemorrhage big size, then treatment is usually used with the application of “Troxevasin” or “Heparin” ointment to the injured area 2 times a day.

We looked at what hemorrhages are. The causes of their occurrence and treatment are also described.

Hemorrhage: causes, symptoms, treatment

Hemorrhagic syndrome is a temporary or chronic damage to vascular tissue that results in random bleeding that can appear in a variety of areas throughout the body. As a rule, chronic forms of this disease appear only in later years, since with age the blood vessels become weaker. What causes this disease and how it manifests itself, we will consider in this article.

Causes

Hemorrhage is a pathological release of blood from the lumen of blood vessels or through their tissues into the space around them (skin, mucous tissues, internal organs). There are several types of hemorrhage, which are directly related to the reasons for their formation:

Skin hemorrhage. The disease appears when blood begins to penetrate the epidermal tissue. There are two types of such hemorrhage:
- subcutaneous;
- hemorrhage in the lower layers of the epidermis, forming hematomas and bruises.

Damage to the capillaries leads to the formation of visible blood-colored lesions. This hemorrhage is the result of mechanical tissue damage (bruise, fracture, rupture of ligaments or muscles).

Expulsive hemorrhage. Manifests itself as a severe complication after surgery on the eyeball or when severe injury. Bleeding occurs due to rupture of the ciliary arteries, which are located in the sclera of the eyes.

Gastric hemorrhage is the most common and well-known disease, which is popularly called gastritis and stomach ulcers. Due to the thinning of the vessels in the epigastric region, hemorrhage occurs, and blood fills the stomach.

Hemorrhage of blood vessels of mucous tissues. They are mainly caused by pathological diseases, such as disruption of hemostasis, hemophilia, von Willebrand disease, thrombocytopathy.

Among the many reasons that can cause hemorrhage different types can be distinguished:

high blood pressure;
leukemia or leukemia;
aneurysm;
Nishimoto's disease;
vasculitis;
hypertension;
hypertensive crisis;
serious disorders of the nervous system.

Hemorrhage manifests itself very quickly, one might even say rapidly, so it is inappropriate to talk about prevention or early treatment of this pathology.

Symptoms

The symptoms of hemorrhage are very clearly visible in external signs. Since blood enters the subcutaneous space, you can observe redness in certain areas of the body, which are the most different forms and sizes. With more serious injuries, painful hematomas are formed, which are characterized by a bluish color.

With expulsive hemorrhage, redness of the sclera of the eyes occurs. In the case of gastric hemorrhage, the following appears:

nausea;
stool comes out with blood;
Blood may also be present in the urine.

Hemorrhage is characterized by a general loss of strength, pain on palpation damaged areas, dizziness, nausea and vomiting. When the sclera of the eyes is damaged, vision deteriorates.

Diagnostics

There is absolutely no difficulty for a doctor to recognize this disease, but identifying the reason why it arose is a little more difficult. At similar diseases, doctors prescribe:

A general blood test for the number of leukocytes to determine the presence of an inflammatory process in damaged tissues.
MRI – magnetic resonance imaging. It will help determine the location of vascular rupture in any type of hemorrhage.
X-ray examination. With its help, you can see possible accumulation of blood in tissues and internal organs.

In general, all these methods are absolutely sufficient to establish an accurate diagnosis, detect the damaged area and find out the cause.

Treatment

At prescribed by the doctor diagnosis, first of all, it is necessary to eliminate the first symptoms and prevent further damage to vascular tissues. This can only be done with the help of medications. In such cases, doctors prescribe:

Drugs that normalize blood pressure to reduce the intensity of blood flow and its leakage into internal organs. These may be Captopril, Andipal, Enap.
Drugs that increase blood clotting for the fastest healing of damaged vessels - Vikasol, Piracetam, Detralex.
Anti-inflammatory painkillers - Nimesil, Ortofen, Movalis.
At severe inflammation epidermal tissue, the presence of bruises and bumps, ointments and other means are often used that speed up the process of resorption of accumulated blood - Indovazin, Liniment, Bodyaga, Troxevasin.

Based on all of the above, we can conclude that hemorrhage is not a disease, but just a symptom common to many diseases. But this symptom also has its original sources and can cause complications, so you should not expect that everything will heal on its own; you must definitely consult a doctor.

Hemorrhagic syndrome - types and causes. Symptoms and consequences of hemorrhagic syndrome in children and adults

Hemorrhagic diathesis appears when there are changes in the links of hemostasis (such as damage to vascular wall) and occur in a state of increased bleeding in both an adult and a child’s body. Hemorrhagic disease is bleeding of the mucous membranes. It can be detected by passing a detailed blood test.

What are hemorrhages

In medicine, spontaneous bleeding from blood vessels in any part of the body is called hemorrhage. This pathological syndrome manifests itself in patients in response to external influences or in the presence of internal diseases. Hemorrhagic disease occurs due to damage to the integrity of the walls of blood vessels, a decrease in the number of platelets, and a violation of coagulation hemostasis. In this case, blood flows beyond the boundaries of the blood vessel through the damaged area. The types of abnormalities depend on which part of the body they appear in.

Hemorrhagic syndrome is typical for what diseases?

Among the forms of hemorrhagic diseases, hereditary and acquired disorders of hemostasis are distinguished. The latter are associated with multifactorial disorders of the blood coagulation system (for example, acute DIC syndrome), defeat blood vessels dismetabolic, immune, toxic-infectious, immunocomplex origin, abnormalities of adhesive proteins in blood plasma, damage to platelets and megakaryocytes. Hereditary hemorrhagic diseases are caused by:

Note!

The fungus won't bother you anymore! Elena Malysheva tells in detail.

Elena Malysheva - How to lose weight without doing anything!

pathologies of plasma factors of the blood coagulation system;
hereditary disorder of hemostasis;
genetic structural changes in the vascular wall.

Hemorrhagic diathesis in children

Due to a lack of vitamin K, hemorrhagic syndrome of newborns can develop, among the signs of which are: hemorrhagic skin rashes, umbilical bleeding. May happen intestinal bleeding or intracerebral hemorrhage. Doctors call following reasons the occurrence of hemorrhages in newborns: during pregnancy, the mother took phenobarbitals, salicylates or antibiotics. Hemorrhagic disease in children occurs when:

neoplastic lesions of connective tissue;
thrombocytopenia;
coagulopathies;
vasopathy;
hemophilia.

Pathogenesis of hemorrhagic syndrome

As a mechanism for the development of hemorrhagic syndrome and its manifestations, doctors describe the following picture of pathogenesis:

impaired coagulation (DIC) and platelet production;
changes in collagen structure, fibrinogen properties, vascular walls:
- for circulatory disorders;
- decreased neurotrophic function of the central nervous system;
- violation of the angiotrophic function of platelets.

Hemorrhagic diseases - classification

The following types of hemorrhagic syndromes have been described in medicine: hematoma, petechial-spotted, mixed bruise-hematoma, vasculitic-purpuric, angiomatous. The listed types differ in the nature of their manifestation and causes. In each individual case, it is necessary to follow the individual treatment tactics chosen by the attending physician. Description of hemorrhagic diathesis according to the type of disease:

The hematoma type is caused by chronic genetic bleeding. This serious disease due to decreased coagulability manifests itself in the patient in the form of painful sensations with hemorrhages in the joints (hemarthrosis), dysfunction of the musculoskeletal system. In case of injury, internal hematomas form extensive swelling in the soft tissues, which causes pain.
The petechial-spotted type is also called the bruise type because external manifestations on the body in the form of bruises, as can be seen in the photo. Appears in cases of blood clotting disorders (lack of coagulation factors, hypo- and dysfibrinogenemia), thrombocytopathy and thrombocytopenia (thrombocytopenic purpura).
Microcirculatory-hematoma, or mixed bruise-hematoma bleeding develops in the presence of immune inhibitors of factors IX and VIII in the blood, an overdose of thrombolytics and anticoagulants, disseminated intravascular coagulation, von Willebrand's disease, severe deficiency of prothrombin complex factors and factor XIII. Externally, this type of disease manifests itself through petechial-spotted skin hemorrhages, hematomas large sizes in the retroperitoneal region and intestinal wall, petechial skin rash.
Symptoms of the vasculitic purpuric type are skin rash red (erythema). With the disease, there is a tendency to bleeding in the intestines and inflammation of the kidneys (nephritis), immune and infectious vasculitis, and disseminated intravascular coagulation syndrome.
The angiomatous type develops in the area of arteriovenous shunts, angiomas, and telangiectasia. This type of disease is characterized by hemorrhages in the area of vascular anomalies and persistent bleeding of permanent localization.

Hemorrhagic symptoms may develop with vascular anomalies, disorders of coagulation hemostasis, enzyme activity, blood coagulation system, when taking medicines that interfere with platelet aggregation. Experts were able to identify a type of disease in which there is a high risk of hemorrhage:

The causes of hemorrhages depend on the primary or secondary form of the disease. The first is characterized by the presence of genetic determination: there is a defective gene in the body that can cause hemorrhagic disease. The secondary form occurs from damage to the walls of blood vessels (with an autoimmune process, mechanical damage, inflammation and chemical intoxication), with secondary thrombocytopenia, DIC syndrome, hemorrhagic vasculitis and deficiency of prothrombin complex factors.

Symptoms of hemorrhagic syndrome

There is a connection between the areas of localization of hemorrhagic diathesis and the clinical picture, intensity of manifestation, and specificity of symptoms of the disease. Signs of hemorrhage in the nasal cavity are manifested by recurrent bleeding from telangiectasia (dilation of small vessels). This manifestation of symptoms is also typical for hemorrhages in the lips, mouth, pharynx and stomach. At the age of up to 30 years and during puberty, the frequency of bleeding from telangiectasia increases. Other signs include:

Treatment of hemorrhagic syndrome

The treatment of hemorrhage depends on the symptoms and cause of the disease in patients. Complex therapy involves: immunoglobulin, plasmapheresis, glucocorticosteroids. For inflammation of blood vessels (vasculitis), non-hormonal immunosuppressants, non-steroidal anti-inflammatory drugs (NSAIDs) are taken, corticosteroid therapy (glucocorticoid) is used and attempts are made to reduce the symptoms of inflammation. For hemophilia A, the missing factor VIII is administered, and for hemophilia B, factor XI is administered. After a detailed blood test, the doctor helps the patient choose treatment tactics.

Among the fundamental principles of therapy are:

symptomatic treatment;
intravenous injection of a synthetic analogue of vitamin K - vikasol, calcium chloride and ascorbic acid;
if necessary, transfusions of blood, its components (platelet, erythrocyte mass) and plasma are carried out;
taking medications that help strengthen the walls of blood vessels (ethamzilate);
for local treatment of hemorrhages the following are indicated: dry thrombin, homeostatic sponge, aminocaproic acid.

Consequences of hemorrhagic disease

If hemorrhages are detected, you should not panic, but you should immediately consult a doctor. With a mild degree of the disease and timely treatment, the prognosis of the disease is favorable. However, there are cases when, with late detection of the disease, severe complications hemorrhagic syndrome, which can be fatal.

Among these consequences are: massive internal bleeding, cerebral hemorrhages, cardiac dysfunction, adrenal insufficiency. The child may experience hypovolemic shock, which manifests itself through a decrease in blood pressure and body temperature, weakness, and pallor. To prevent the described consequences, it is necessary to immediately take the child for a consultation with a pediatrician as soon as symptoms are noticed.

Prevention of hemorrhagic syndrome

Compliance with simple preventive measures can protect against the development of pathologies. A blood test will help identify hemorrhagic bleeding, and you can reduce the risk of its occurrence if:

within half an hour after birth, attach the baby to the breast;
administer vitamin K by injection to children at risk;
administer vitamin K injections during parenteral (intravenous) nutrition;
administer intramuscular vitamin K during or before labor if the mother is taking anticonvulsants.

Hemorrhagic syndrome: symptoms and treatment

Hemorrhagic syndrome - main symptoms:

Hemorrhagic syndrome is a pathological condition characterized by increased bleeding of blood vessels and developing as a consequence of a violation of homeostasis. Signs of pathology are the occurrence of cutaneous and mucous hemorrhages, as well as the development of internal bleeding. The disease can develop at any age - both in newborns and the elderly. There are acute and chronic form this pathological condition. At acute form in children or adults emergency medical care is required, in chronic cases - complex treatment pathology.

Causes

It's hard enough in simple words describe the complex processes of hematopoiesis and their changes, which is why hemorrhagic syndrome develops. If we consider the mechanism of the violation, then it is based on anomalies cellular structure blood vessels, coagulation disorders, as well as enzyme activity and the functions of blood elements responsible for coagulation.

Doctors have identified a number of diseases, in the presence of which a person is likely to develop hemorrhagic syndrome. In particular, this pathological disorder develops with hepatitis, some types of oncology, severe viral infections, liver cirrhosis, as well as with prothrombin deficiency in the blood, hemophilia, leukemia and vasculitis.

There are two forms of the disease:

congenital or primary;
secondary (acquired).

For hereditary (congenital) pathologies, the general criterion is the presence of genetic determination. That is, the human body already has a defective gene, which at any age (from childhood to adult) can cause hemorrhagic syndrome in a person. Acquired hematopoietic pathologies are characterized by damage to the walls of blood vessels due to an autoimmune process, chemical intoxication, inflammation or mechanical damage.

The main reasons causing this pathological disorder include:

To understand what exactly causes the disease, it is necessary to consider what vasopathy and other pathological changes in the blood system are. Vasopathies can cause massive inflammatory processes and genetic defects and they are characterized by increased permeability of the vascular walls. Thrombocytopathy is said to occur when the functions of platelets are impaired, despite the fact that there is a sufficient amount of them in the blood. This can occur both due to genetic mutations and as a result of mechanical, biological or chemical effects on the body of adults and children. Thrombocytopenia is characterized by a decrease in the number of platelets in the blood, while maintaining their functions. This condition may be a consequence of autoimmune processes in the body. In addition, the disorder occurs due to severe intoxication, infections, oncological processes in the body, drug abuse and after exposure to radiation.

Very often the disorder occurs with cirrhosis of the liver. This is due to the fact that the disease causes complex damage to blood vessels, accompanied by their dilation. As a result, symptoms such as bruising on the skin, bleeding from the esophagus, uterus, gums and nose appear. The development of such a pathological condition as hemorrhagic syndrome in cirrhosis of the liver is also due to a violation of its performance, as a result of which the organ cannot participate in the process of producing substances that affect blood clotting.

Varieties

In modern medical practice, there are five main forms of the disease, which can occur in both children and adults. At the same time, hemorrhagic syndrome in newborns is represented by an edematous-hemorrhagic variety of this pathology - the sixth form, which stands apart.

The following types are distinguished:

hematoma, which is a consequence of blood diseases caused by genetic mutations. With this type, extensive bleeding occurs due to injuries in soft tissues, forming bruises on the skin, swelling and swelling of the injury site;
petechial-spotted – caused by hereditary and acquired disorders of hemostasis, as a result of which the patient’s blood clotting is impaired. Manifested by the appearance of bruises of various diameters on the body of children or adults;
the purple appearance of this syndrome, which is usually a consequence of various vasculitides. Its manifestations are erythema on the skin, as well as the development of nephritis and internal bleeding, in particular from the liver and intestines;
The microcirculatory type of the syndrome occurs with von Willebrand disease, disseminated intravascular coagulation syndrome, and with an overdose of drugs that cause disturbances in the hematopoietic system. With this type of pathology, the following symptoms are noted: hemorrhagic hemorrhages on the skin of a petechial nature and the occurrence of large hematomas in the retroperitoneal space;
the angiomatous type of syndrome occurs in areas of vascular pathologies. It is characterized by prolonged bleeding that has a specific localization.

Edema-hemorrhagic syndrome is characterized by changes in the lungs, therefore, at birth, such children have respiratory failure, with the release of bloody foam from respiratory tract. Such children require emergency medical care, since otherwise there is a high risk of death. The main reason for the progression of this type of disease is fetal hypoxia in the mother’s womb.

Symptoms

In the clinical picture of the disease, a special place is occupied by skin syndrome, manifested by petechial hemorrhages on the skin and mucous membranes, as well as the occurrence of hematomas of various diameters throughout the body. They usually appear after a certain traumatic impact, even a minor one.

Another symptom is bleeding of various locations. Bleeding may occur:

In addition, hemorrhages occur in the joints and muscles, which causes impaired mobility and swelling, with the subsequent development of the inflammatory process. In some cases (for example, when blood accumulates in the joints), severe pain is observed.

With the development of hemorrhagic syndrome in liver cirrhosis, the following symptoms are noted:

Very often, with liver cirrhosis complicated by hemorrhagic syndrome, patients die from gastrointestinal bleeding. Therefore, the earlier the pathology is diagnosed, the higher the person’s chance of recovery.

Diagnosis and treatment

Diagnostics is aimed at establishing the cause of the development of pathology and further effective elimination of this very cause. But in acute cases it is often necessary urgent Care, aimed at stopping bleeding and normalizing hemostasis. Therefore, if a person is in critical condition, he is provided with emergency care, and diagnostics are carried out after his condition has stabilized.

Diagnosis in this case consists of laboratory tests that allow you to see an accurate picture of the blood. Coagulation tests are performed, and sometimes a sternal puncture is prescribed. Treatment of the disease depends on the following factors:

stages of the disease;
the reasons that caused it;
degree of severity of the process.

As mentioned above, in most cases, acute forms of a pathology such as hemorrhagic syndrome require the patient to receive emergency care. For this purpose, doctors stop the source of hemorrhage - cryotherapy or hemostatic therapy is used, as well as surgery or laser barotherapy. After stopping the source of hemorrhage or in cases where emergency care is not required, patients with this disorder are prescribed drugs that increase coagulation.

If significant blood loss has occurred, it is indicated replacement therapy– patients are injected with plasma, a concentrate of donor platelets. Treatment also involves the use of heparin, and in some cases the administration of prednisolone is indicated.

Treatment of hemorrhagic syndrome in patients with liver cirrhosis has its own characteristics - in addition, treatment in this case will be aimed at stopping the source of bleeding, and will also include restorative and replacement therapy. It is also necessary to carry out simultaneous treatment underlying disease.

In the same cases, when it comes to congenital hemophilia, treatment cannot be 100% effective. That's why doctors use hormonal drugs in order to normalize blood formation, and such patients need to constantly undergo therapy in order to avoid complications, and are under the supervision of a doctor.

If you think that you have Hemorrhagic syndrome and the symptoms characteristic of this disease, then a hematologist can help you.

We also suggest using our online disease diagnostic service, which selects probable diseases based on the entered symptoms.

Hemorrhagic syndrome, treatment

Hemorrhagic syndrome (HS) is a condition characterized by temporary or permanent bleeding, which is expressed by the spontaneous release of blood from intact vessels.

At normal functioning hemostatic mechanisms of hemorrhage do not develop spontaneously, and injuries to most vessels (with the exception of damage to large arteries, great veins and the vascular network of parenchymal organs) do not threaten the patient’s life due to the local formation of a fibrin clot at the site of damage to the vascular bed. Numerous coagulation defects prevent the physiological implementation of hemostatic reactions, therefore, when gross violations of the hemostasis system, even minor vascular damage can cause the patient’s death. It should also be taken into account that in a considerable number of patients, hemorrhagic syndrome is caused not by vascular injury, but by other causes (inflammatory process, separation of the placenta, destruction of the mucous membrane or hormonally induced rejection of the endothelium during menstruation, etc.).

It is very important to detect a hemostatic defect as early as possible, since patients with even moderate bleeding during and/or after surgery or childbirth can lose a fairly large volume of blood. In such situations, the attending physician will no longer have the opportunity for a more precise diagnosis, since life-threatening hemorrhages often induce consumption coagulopathy, which will result in depression of most components of the hemostatic system (platelets, fibrinogen and many others), which will not allow identifying the underlying hemostatic defect uncontrollable bleeding.

Causes of hemorrhagic syndrome

HS due to blood clotting disorders (coagulopathy):

Hemophilia.
Lack of prothrombin.
Overdose of anticoagulants.

HS due to impaired platelet formation:

Werlhof's disease.
Symptomatic thrombocytopenia.
Thrombocytopathies.

3. HS due to vascular damage (vasopathy):

Hemorrhagic vasculitis.
Hemorrhagic telangiectasia.

There are 5 types of bleeding

Hematoma type. It is characterized by massive painful hemorrhages in the muscles, as well as in large joints. This type is characteristic of hemophilia.
Petechial-spotted type (bruise). It is characterized by painful superficial bleeding into the skin and bruising. Hemorrhages occur with negligible trauma (for example, when measuring blood pressure). This type is characteristic of thrombocytopathy, and may be due to a lack of fibrin and certain coagulation factors (X, V, II).
Mixed bruise-hematoma type. It is characterized by a combination of petechial-spotted bleeding with large hematomas in the absence of hemorrhages in the joints (in contrast to the hematoma type). This type is observed with factor XIII deficiency, overdose of anticoagulants, and constitutional thrombocytopathies.
Vasculitic purpuric type. It is characterized by skin hemorrhages in the form of purpura. This type is characteristic of hemorrhagic vasculitis and thrombocytopathy.
Angiomatous type. It is characterized by recurrent bleeding specific localization. This type is observed with telangiectasias and angiomas.

Petechia is a small spot (1-3 mm) of a certain shape of purple-red color. Does not disappear when pressed.

Purpura is a subcutaneous layer of tissue, altered due to hemorrhage, purple or red-brown in color, easily visible through the epidermis.

Echimosis is a hemorrhagic spot (larger than petechiae) of blue or purple color.

Symptoms and signs of hemorrhagic syndrome

The clinical picture consists of symptoms of bleeding of various locations and hemorrhagic skin rashes.

Bleeding may occur spontaneously or under the influence external factors: hypothermia, physical stress, minor injuries. Skin manifestations of hemorrhagic diathesis are varied - from small petechial rashes and bruises to hemorrhages merging with each other with an ulcerative-necrotic surface. The variety of clinical manifestations of the syndrome corresponds to five types of bleeding.

Hemorrhagic manifestations can be combined with articular syndrome (arthralgia, hemarthrosis), abdominal syndrome, and there may be an increase in temperature.

Hemorrhagic syndrome can be observed in diseases such as malignant neoplasms, hepatitis and cirrhosis of the liver, leukemia, sepsis, systemic diseases connective tissue, severe infections, etc. In such cases clinical picture will consist of the symptoms of the underlying disease and the symptoms of hemorrhagic diathesis.

Laboratory and instrumental studies

Complete clinical blood test with platelet count.
Blood clotting time.
Duration of bleeding.
Retraction time blood clot.
Blood for prothrombin and fibrinogen.
Plasma tolerance to heparin.
General urine analysis.
Sternal puncture according to indications.

If necessary, the scope of laboratory tests can be expanded (thrombin and prothrombin time, determination of the activity of coagulation factors, determination of antihemophilic globulin, study of the adhesive-aggregation function of platelets, recalcification time).

Stages of diagnostic search

The basis of the diagnostic algorithm is the presence of hemorrhagic syndrome. For this purpose, when collecting complaints, it is necessary to clarify the location and nature of bleeding, the frequency of bleeding, find out whether the bleeding is associated with any provoking factor or occurs spontaneously, etc.
The second stage is the history and physical examination. If the disease manifests itself with early childhood, it is natural to assume that the disease is hereditary or congenital (in this case, it is important to collect information about the presence of similar symptoms in close relatives).

Since most acquired hemorrhagic diathesis are symptomatic, it is necessary to clarify the presence of the underlying pathology. These may be liver diseases, leukemia, radiation sickness, aplastic anemia, systemic connective tissue diseases. Bleeding may be associated with the action of drugs that affect platelet function (aspirin) or blood clotting (anticoagulants).

An objective examination involves a thorough examination skin, which will allow us to determine the nature and type of hemorrhagic manifestations. Inspection of the mucous membranes is mandatory, since hemorrhages can be located not only in the skin, but also in the mucous membranes. In some cases, angiectasias can be detected in the form of vascular spiders or bright red nodules protruding above the surface of the skin. They are characteristic of hereditary vascular dysplasias (Rendu-Osler disease) or can be acquired (for example, with cirrhosis of the liver).

Enlargement of joints with limited mobility occurs in hemophilia. These disorders are a consequence of bleeding in the joints (hemarthrosis).

With hemorrhagic vasculitis, there may be a slight enlargement of the lymph nodes. Autoimmune thrombocytopenia is accompanied by an enlarged spleen.

Tests for capillary resistance (fragility) may have diagnostic value:

Rumple-Leede-Konchalovsky symptom.
Pinch symptom - if you pinch the skin under the collarbone, pinpoint hemorrhages will appear. When a suction cup is applied to the skin, pinpoint hemorrhages appear. These tests are positive in cases of thrombocytopenia, hemorrhagic vasculitis, and taking anticoagulants.
Additional research methods will help establish a final diagnosis.

Differential diagnosis of hemorrhagic syndrome

Bleeding can be detected in diseases whose pathogenesis does not involve a defect in the hemostatic system, so the greatest difficulty in examining such patients is to determine the etiology of the hemorrhagic syndrome. With defects in the hemostatic system, hemorrhages of different localization and other clinical manifestations of hemostatic dysfunction are usually combined with each other (for example, epistaxis and uterine bleeding), forming an idea of the systemic nature of manifestations, which is very characteristic of most hemorrhagic diseases. In addition, with hemorrhagic diseases and syndromes, recurrent hemorrhages are often combined with chronic posthemorrhagic anemia. However, in a number clinical cases There are also local hemorrhagic manifestations without other symptoms of bleeding and iron deficiency. In the presence of local hemorrhages or low-symptomatic bleeding, only laboratory testing of the hemostatic system helps to exclude hemorrhagic disease. If one or two clinical manifestations of bleeding are detected, it is useful to consider their relationship with a hemorrhagic disease.

When carrying out differential diagnosis of various types of hemorrhagic diathesis, one should be guided by the following considerations.

Identification of coagulopathies from the group of hemorrhagic diathesis is based on the clinical features of bleeding (hematoma type, often hemarthrosis, delayed bleeding), laboratory coagulation studies (extension of clotting time, thrombin, prothrombin and thromboplastin time), as well as negative results of capillary fragility tests.
Hemorrhagic diathesis due to impaired platelet formation is characterized by a petechial-spotted type of bleeding and bleeding from the mucous membranes, positive tests for capillary fragility (symptom of a tourniquet, pinch), a decrease in the number of platelets or their functional failure.
Vasopathies are diagnosed by vasculitic purpuric or angiomatous type of bleeding and unchanged laboratory data.
The diagnosis of hereditary forms is based on the study of family history and laboratory data.
The diagnosis of symptomatic forms is based on identifying the clinical signs of a particular (main) disease, taking into account the characteristics of the manifestation of hemorrhagic syndrome. Other purchased hemorrhagic diathesis can be diagnosed only after excluding symptomatic variants.

Paramedic tactics for hemorrhagic syndrome

In case of bleeding, provide emergency assistance to the extent necessary and possible.
If a patient with hemorrhagic syndrome is identified, give a referral for consultation with a doctor.
After establishing a diagnosis, the paramedic monitors patients who are subject to medical examination, working in contact with the doctor.
The paramedic must know all the patients in his area who suffer from hemophilia and have an understanding of modern ways its treatment (coagulation factor VIII concentrate - in mild cases 10-15 units/kg, in more severe cases 25-40 units/kg per course of treatment; for hemorrhages in the cavity of the skull, chest, abdomen, the initial dose is 40-50 units. /kg).

Hemorrhage

Hemorrhage is a pathological hemorrhage of varying severity in certain parts of the body that occurs when external influences or with internal pathologies of the body. Patients prone to the development of hemorrhages note the spontaneous appearance of these visual signs of increased bleeding, which are not represented so much cosmetic defect, how many can be a symptom of a more severe pathology of the blood and blood vessels. Sometimes the appearance of hemorrhage is accompanied by the release of blood into the external environment, however, in most cases there is interstitial accumulation of blood.

Causes of hemorrhage

The development of hemorrhage can be caused by both a traumatic effect on an unchanged vascular wall, and without the presence of trauma, provided there are pathologically altered vessels. The cause of impaired vascular wall permeability can be congenital genetic abnormalities (hemophilia, von Willebrand syndrome), however, pathological bleeding is most often observed among patients suffering from acquired blood and vascular pathology in the form of thrombocytopathy, coagulation disorders, hemorrhagic vasculitis and disseminated intravascular coagulation syndrome.

The formation of hemorrhages on the skin and in the subungual bed is promoted by various underlying dermatological diseases (chronic dermatoses, psoriasis). Most dermatologists consider the development of subungual hemorrhage in a patient against the background of complete well-being to be the first clinical sign of the onset of psoriasis.

For all hemorrhages of different localization, a characteristic feature is the connection between their occurrence in the presence of predisposing factors, which include depression and psycho-emotional tension, prolonged use of hormonal drugs, as well as traumatic exposure.

Symptoms of hemorrhage

Clinical manifestations, their intensity and specificity directly depend on the location of hemorrhages. Thus, the most common clinical form of this pathology is subcutaneous hemorrhages that arise as a result of medical manipulations, in particular intramuscular and subcutaneous injections. Intravenous administration of the drug may also be accompanied by the development of hemorrhages due to the existing through damage to the venous vessel, which is extremely rare. The degree of hemorrhagic manifestations in this situation directly depends on the thickness of the injection needle and the properties of the injected drug.

The duration of subcutaneous hemorrhages can vary significantly, which is explained by the individual regenerative abilities of each organism. However, all subcutaneous hemorrhages that occur with intramuscular injections are characterized by a longer course compared to subcutaneous ones, since muscle contains a larger number of vessels, the diameter of which exceeds the diameter of the subcutaneous vessels. In most situations, subcutaneous hemorrhages do not require specific drug treatment and disappear on their own within a short time.

When a certain amount of erythrocyte blood cells enters the thickness of the skin, which occurs with pathological permeability of the vascular wall of the capillaries, signs of hemorrhage form on the skin. Visually, these pathological changes appear in the form of intensely hyperemic spots, merging in places, or in the form of a single pinpoint rash. Hemorrhages localized on the skin are characterized by pathomorphological changes in the form of a change in the color of the hemorrhage from intense red to brownish-yellow, which is explained by transformations of hemoglobin.

As a rule, the presence of hemorrhages on the skin does not require the use of therapeutic measures and they disappear on their own within a short period of time. A type of skin hemorrhage is subungual hemorrhage, which looks like pinpoint spots or linear areas of various colors and shapes, localized under the nail bed. In addition to the presence of hemorrhages, the nail plate itself changes, becoming dull yellow, uneven and characterized by increased fragility. Very often, subungual hemorrhages are accompanied by a fungal infection, which requires immediate medical treatment.

In a situation where a patient has signs of inflammatory changes in the gastric mucosa, which is observed with erosive type gastritis, gastric hemorrhages develop. When the organs of the gastrointestinal tract are damaged, so-called submucosal hemorrhages develop, which long time may be completely asymptomatic. The first symptoms indicating the development of gastric hemorrhages are unmotivated weakness, dizziness, nausea, which has no connection with food intake. At the stage of advanced clinical symptoms, the patient experiences frequent episodes of vomiting, and the vomit has a characteristic dark color, which is a pathognomonic symptom of gastrointestinal bleeding. This pathological condition requires careful attention from the attending physician and is the basis for hospitalization of the patient for the purpose of using specific drug treatment.

Internal hemorrhages also include hemorrhages in liver cirrhosis, observed with pronounced portalization of blood flow. The most pathognomonic sign of hemorrhage in liver cirrhosis is esophageal bleeding, which can have varying degrees of intensity. Subsequently, in addition to vomiting, the patient experiences stool mixed with dark blood.

Hemorrhages on the face are most often localized in the projection of the eyeballs and in the paraorbital region, and are small spots of dark or bright red color, depending on the duration of their course. Punctate hemorrhages in the white of the eye are not accompanied by the development of pain or visual disturbances, however, some patients note the appearance of a sensation of flies flashing before the eyes and the doubling of objects. In a situation where the patient has signs of expulsive hemorrhage, as a complication surgical intervention on the organs of vision or traumatic effects on the paraorbital area, it is necessary to urgently hospitalize him in an ophthalmological hospital. Signs indicating the development of this complication are strong pulsating headache, nausea and vomiting, dizziness, feeling of “fullness” in the eyeball.

The most severe clinical form of hemorrhage is subarachnoid, in which a large volume of fresh blood accumulates in the subarachnoid space. This pathological condition belongs to the category of acute emergency conditions and is accompanied by the development of severe clinical symptoms in the form of intense pain in the head of a pulsating nature, varying degrees of impairment of consciousness from short-term fainting to deep coma, and the appearance of positive meningeal signs. It is impossible to establish visually subarachnoid hemorrhage, but such special methods like computed tomography and analysis cerebrospinal fluid allow you to correctly verify the diagnosis in a short time.

Treatment of hemorrhage

When establishing a diagnosis and determining management tactics for a patient who has signs of hemorrhage, it should be taken into account that some forms of this pathological condition are prone to the development of complications, and therefore all patients of this profile need dynamic monitoring. Complications of hemorrhage are the inflammatory transformation of hemorrhage, as well as the development of post-hemorrhagic anemic syndrome, which in severe cases can cause death.

The feasibility of using medication is determined taking into account the severity of the patient’s condition, the clinical form of hemorrhage, its intensity and ability to provoke complications. So, for example, for intradermal and subcutaneous non-extensive hemorrhages, it is possible not to use therapeutic measures at all, and for large hemorrhages, it is sufficient to use local treatment (applying Heparin or Troxevasin ointment twice a day to the affected area).

For hemorrhages in the eyeball, ophthalmologists usually use combination treatment(local in the form eye drops"Emoxipin" 1 drop twice a day, and medicinal). In a situation where drug treatment ineffective, ophthalmologists recommend surgical removal of the blood clot using vitrectomy.

Hemorrhages in the stomach detected during endoscopic examination require only basic treatment background disease (erosive gastritis), however, at the first signs of gastrointestinal bleeding, even of low intensity, hospitalization of the patient in a surgical hospital is indicated. The fundamental stage of treatment in this situation is replacement therapy using intravenous infusion of fresh frozen plasma and parenteral administration of Vikasol to daily dose 30 mg.

Hemorrhage – which doctor will help? If you have or suspect the development of hemorrhage, you should immediately seek advice from doctors such as a hematologist or dermatologist.

Hemorrhagic syndrome is a violation of the hemostatic system - one of the main biological processes in the body. The main functions of this system are to preserve blood in a liquid state and stop internal bleeding when the vascular walls are damaged. When the integrity of the vessel is compromised, blood penetrates beyond its boundaries, and a specific red and bluish coloration appears on the skin. In the photo below, a patient with hemorrhagic syndrome looks as if part of his body is covered with bruises and red spots. Of particular danger are mucosal hemorrhages and internal bleeding.

The disease develops at any age. According to statistics, women are more susceptible to it than men. In the pathological course of pregnancy it occurs in newborns.

Treatment of the syndrome involves an integrated approach, which is based on therapeutic methods aimed at improving the blood clotting process. In some cases, when there is a risk of loss large quantity blood, it is important to provide immediate medical attention.

Reasons for the development of pathology

Hemorrhagic syndrome occurs due to disruption of complex hematopoietic processes.

In the presence of certain diseases, the likelihood of the formation of this syndrome is high. At risk are patients diagnosed with:

hepatitis - inflammatory processes in the liver;
cirrhosis of the liver, when the organ is not able to produce substances involved in the process of blood clotting;
oncological neoplasms;
infectious and viral diseases;
hemorrhoidal syndrome;
hemophilia - a condition of the body associated with a violation of the coagulation process (blood clotting);
vasculitis – inflammation of blood vessels of an immunopathological nature;
thrombocytopathy - with a sufficient platelet content, a violation of their functions is observed;
thrombocytopenia – while platelet functions are preserved, their number decreases.

In medical practice, there have been cases where changes in the process of blood clotting occur under the influence of certain medications.

Often, hemorrhagic syndrome develops in newborns. It usually appears a few days after the baby is born. Among the factors influencing its formation are:

prolonged use by the expectant mother of certain medications, the components of which are able to penetrate to the fetus through the placenta (anticonvulsants, antituberculosis drugs, antibiotics, anticoagulants, phenobarbital);
birth of a child before the due date;
fetal hypoxia;
the mother has diseases that are at risk.

The causes of hemorrhagic syndrome are also hereditary and associated with gene mutation.

Classification and main features

IN medical science There are two forms of the syndrome:

primary (congenital), due to a person’s genetic predisposition;
secondary (acquired), arising due to damage to blood vessels of various types.

Depending on what part of the body the lesion is located and what caused it, several types of the disease are distinguished. Each of them has characteristic symptoms and features of the therapeutic technique.

Type of hemorrhagic syndrome	Main features
Hematoma	A hemorrhagic disease in children, particularly infants, caused by genetic changes. Develops in hemophilia. Soft tissues are injured and painful sensations occur. The damaged area swells and a slight swelling appears. The skin becomes bruised due to heavy bleeding. Motor functions are gradually impaired
Microcirculatory-hematoma (mixed)	Due to small effusions of blood, petechiae - small red dots - appear on the skin and mucous membranes. This occurs with bruises, after an injection, or as a result of friction of a pathological area.
Petechial-spotted (bruised)	The main symptom is bruises appearing on the patient’s body. The skin acquires a bluish tint, and yellowness appears in places. Blood clotting is impaired.
Angiomatous	Bleeding from the nose that does not stop for a long time. Vomiting with blood. Small angiomas - small moles Red. Concomitant diseases of the gastrointestinal tract associated with damage to the stomach and liver.
Vasculitic purpuric	A bright red or bluish rash that primarily covers the lower extremities. The rash reaches a size of 4 mm, slightly rising above the surface of the skin.

Diagnostic tests

The main goal of diagnostics is to establish the cause of the disease, on the basis of which further treatment is prescribed. If a person has an acute form of the syndrome, it is necessary to first stop the bleeding and stabilize the condition.

The main diagnostic method for suspected hemorrhagic bleeding is laboratory tests: a detailed blood test and a urine test, which allows you to see the whole picture. The platelet count in peripheral blood is important. Additional examination methods include simple coagulation tests and sternal puncture.
When making a diagnosis, the duration of bleeding, as well as the nature of blood clotting, are taken into account.

Therapeutic measures

Treatment of hemorrhagic syndrome in adults depends on several factors:

causes of the disease;
stages of development;
the nature of the course and severity of the disease.

Urgent Care

In the acute form of hemorrhagic syndrome, emergency care may be needed. It is important to stop the source of damage. For this purpose, the following therapeutic methods are used:

conservative hemostatic therapy;
cryotherapy;
laser barotherapy;
surgical intervention.

Drugs

When first aid is provided and the bleeding is stopped, the patient is prescribed drugs that have a positive effect on the coagulation process. Modern pharmaceuticals have a large number of drugs that improve blood clotting.

In cases of significant blood loss, replacement treatment, involving the administration of plasma, is necessary. The use of heparin and prednisolone is possible.

If hemorrhagic syndrome occurs against the background of any diseases, treatment has characteristic features. Therapeutic measures are aimed not only at stopping the pathological focus, but also at eliminating the concomitant illness.
For some diseases, it cannot be guaranteed that treatment will be highly effective. For example, with a congenital type of hemophilia, it is necessary to take hormonal drugs, the action of which is aimed at normalizing the blood circulation process. Patients must be under close medical supervision and follow all his recommendations.

Home Recipes

Facilities traditional medicine cannot replace drug therapy. However, their use has a positive effect on the condition of the walls of blood vessels. Only an integrated approach that combines all types of therapy can have the desired effect. Useful for hemorrhagic syndrome are green varieties of apples, cherries, red grapes, raspberries, strawberries, currants, sea buckthorn, red pepper, rowan, rose hips, buckwheat, yarrow.

They have a whole complex of vitamins and nutrients that strengthen blood vessels and increase blood clotting.

With all the effectiveness of medicines, as well as mixtures and decoctions prepared according to folk recipes, it is necessary to exclude those components that are allergens. Carefully read the instructions for contraindications and side effects. If the body is individually intolerant to the components of the drug, its use is excluded.

Hemorrhagic vasculitis is considered a disease that is a type of immune vasculitis of small vessels and is characterized by advanced education immune complexes, increased permeability of vascular walls.

This pathology can develop 2-3 weeks after acute tonsillitis, influenza or scarlet fever. Hemorrhagic vasculitis is more common in children than in adults.

Children aged 4 to 12 years are especially susceptible to the disease. Boys get sick 2 times more often than girls.

Causes

Why does hemorrhagic vasculitis occur, and what is it? Hemorrhagic vasculitis is also called Henoch-Schönlein disease or capillary toxicosis. The disease is an aseptic (without infection) inflammation of the capillaries caused by the damaging effects of immune complexes. Capillary toxicosis manifests itself as hemorrhages (hemorrhages), impaired intravascular coagulation and impaired blood circulation in small blood vessels.

The principle of the mechanism of development of hemorrhagic vasculitis is the formation of immune complexes. During circulation through the blood, these complexes can be deposited on internal surfaces walls of small vessels and thereby cause damage with subsequent aseptic inflammation.

When the vascular wall becomes inflamed, its elasticity decreases. As a result, it becomes permeable and forms gaps, which leads to fibrin deposits and blood clots. Based on this, pathological sign vasculitis - microthrombosis and hemorrhagic syndrome (bruising).

Classification

Depending on the clinical variant currents hemorrhagic vasculitis occurs:

skin;
articular;
abdominal (that is, from the stomach);
renal;
combined. Any combinations are possible. The most common variant is the skin-articular variant, which is otherwise called simple.

Depending on the flow option the disease may be:

lightning fast (within several days);
acute (up to 30-40 days);
protracted (for 2 months or more);
recurrent (recurrence of signs of the disease 3-4 times or more over several years);
chronic (clinical symptoms persist for more than 1.5 years or more) with frequent or rare exacerbations.

Activity level diseases:

small;
average;
high.

Clinical manifestations

Frequency of the main clinical manifestations of hemorrhagic vasculitis in children and adults:

spotty rashes on the skin (skin hemorrhagic rash) - 100%;
articular syndrome (pain in ankle joints) - 70%;
abdominal syndrome (abdominal pain) - 60%;
kidney damage - 30-35%;

This disease can affect blood vessels in any area, including the kidneys, lungs, eyes, and brain. Hemorrhagic vasculitis without damage to internal organs is the most favorable disease of this entire group.

Symptoms of hemorrhagic vasculitis

In the case of hemorrhagic vasculitis, the symptoms are very varied, but all patients experience skin lesions. It can manifest itself at the very beginning of the disease, or after the appearance of other symptoms. The most typical appearance is purpura - small-spotted (1-3 mm) hemorrhages that are palpable. This rash is symmetrical and is initially located on the feet and legs; later it can spread higher. In addition to purpura, other elements of the rash may also appear (vesicles, petechiae, erythema and even areas of necrosis).

In 70% of patients, symptoms of hemorrhagic vasculitis such as damage to the articular surfaces are detected. This sign often occurs along with rashes in the first week of the disease. Damage to joints can be minor and cause short-term pain, but it can also be more extensive, when not only large (ankle and knee) but also small articular surfaces are affected. Swelling occurs and the shape of the articular surface changes, and pain can last from 2 hours to 5 days. However, the disease does not cause severe deformation of the articular surfaces.

Damage to the gastrointestinal tract is the most severe. Sometimes abdominal pain appears even before the rash. They occur when hemorrhages appear on the intestinal wall and are cramping in nature. Often such pain occurs in the navel, in the right iliac, subcostal region and resembles the picture of an acute abdomen caused by appendicitis, intestinal obstruction or perforation of an ulcer. The pain lasts mostly for three days. But sometimes up to ten days. They are often accompanied by nausea and bloody vomiting, as well as the appearance of blood in the stool. In some cases, intestinal bleeding develops, which is accompanied by a sharp decrease in blood pressure and collapse.

More rare signs of vasculitis include kidney damage in the form of glomerulonephritis and pulmonary syndrome, which is manifested by cough and shortness of breath.

Differences in symptoms between children and adults

In adults:

The onset of the disease is delayed, the symptoms are milder.
Abdominal syndrome occurs in only 50% of patients and is rarely accompanied by nausea and vomiting.
Kidney damage leads to the development of chronic diffuse glomerulonephritis, with the formation of chronic renal failure.

In children:

More than 30% of children develop fever.
Characteristic is the acute onset and course of the disease.
Abdominal syndrome is accompanied loose stools streaked with blood.
Often the kidneys are involved in the process from the very beginning, with hematuria and proteinuria detected in urine tests.

Hemorrhagic vasculitis: photo

What hemorrhagic vasculitis looks like on the legs, we offer detailed photos of the symptoms for viewing.

Complications

Possible complications of hemorrhagic vasculitis include:

intestinal obstruction;
perforation of stomach and intestinal ulcers;
peritonitis;
posthemorrhagic anemia;
DIC syndrome with thrombocytopenia;
thrombosis and heart attacks in organs;
cerebral disorders, neuritis.

Complications with hemorrhagic vasculitis occur only in cases of untimely treatment, so it is very important to start treatment as quickly as possible. It is known that any disease is much easier to treat at the beginning of its development. Self-medication, uncontrolled use of medications or traditional medicine will lead to a deterioration in the patient’s condition.

Diagnostics

If hemorrhagic vasculitis is suspected, the doctor examines the patient, collects anamnesis, prescribes laboratory and diagnostic examinations, which will help to create a complete picture of the disease and prescribe appropriate treatment.

Main diagnostic methods The following examinations are considered hemorrhagic vasculitis:

Hemorrhages are hemorrhages varying degrees gravity in different areas body. The cause of this disease can be both external and internal pathologies. Very often, hemorrhages are expressed in the accumulation of blood inside the tissue, but there are cases of blood leaking into the external environment.

Why do hemorrhages occur?

The cause of bleeding is often high permeability of the vessel wall or its disruption. Violation of the integrity of the vessel occurs due to mechanical trauma. The reasons why blood leaks through the walls of blood vessels are:

Congenital genetic pathologies(hemophilia);

Acquired pathology of the circulatory system (thrombocytopathy, blood clotting disorders, DIC syndrome and hemorrhagic vasculitis);

Diseases of a dermatological nature, such as psoriasis and chronic dermatoses.

Almost all types of hemorrhages have a close connection with psychological tension, depression and the use of hormonal medications.

Types of hemorrhage by causes

Depending on the causes of hemorrhage, they are divided into three types:

Bleeding caused by mechanical damage to the vessel;

Bleeding that occurs as a result of a decrease in the thickness of the vessel walls;

· bleeding caused by disruption of the integrity of the walls of blood vessels due to exposure to certain chemicals or infections.

Types of hemorrhage by location

Hemorrhages can be divided into:

· internal (hemorrhage into organs and tissues);

·external;

parenchymal (bleeding from tissues that form organs);

arterial (intense flow of blood from damaged arteries);

·venous (calmer bleeding from damaged veins);

capillary (bleeding from small vessels).

Main symptoms of internal bleeding

Manifestations of hemorrhage depend on the type of bleeding and its location. While external bleeding is fairly easy to detect, it is often imperceptible. It can be identified by a number of specific symptoms, such as:

These are common symptoms of internal bleeding. There are also a number of specific signs characteristic of individual species hemorrhages.

Hemorrhages at the injection site. What is this?

Very often, after an injection, complications occur during the treatment process. Arising as a result of hemorrhage, this is local bleeding that occurs due to tissue damage. As a rule, over time, the resulting blood stain goes away on its own, but in some cases the doctor prescribes water-soluble medications. Bleeding occurs due to a through puncture of the vessel and is not as pronounced as with injections into the muscle.

Why do skin hemorrhages occur?

In most cases, hemorrhages on the skin occur due to hemorrhage or blood leaking through the vessel wall into the skin tissue. They look like blood-colored spots on the skin. Throughout the course of the disease, hemorrhages on the surface of the skin tend to change their color from bright red to greenish-yellow. Special treatment not provided in this case. Over time, these spots resolve on their own. Hematomas can be classified as skin hemorrhages.

Hemorrhages of the gastrointestinal tract

In case of damage to the organs of the gastrointestinal system, bleeding often occurs, so-called submucosal hemorrhages. This type of hemorrhage is particularly dangerous, as it tends to occur for some time without visible symptoms. A person experiencing this type of bleeding first of all develops general malaise, causeless nausea, and dizziness. In this case, the patient must be under the supervision of a doctor and undergo a specially prescribed course of drug treatment.

Why are hemorrhages dangerous?

Hemorrhages are a rather insidious phenomenon. Its severity directly depends on the area of the damaged area and the intensity of bleeding. And although such minor injuries, as a rule, resolve on their own, there are cases when the site of hemorrhage festeres, which requires surgical intervention. Sometimes hemorrhages can destroy tissue, which can also lead to serious consequences. In this case, the lungs and heart are very dangerous.

Which doctor should I go to?

Whatever the nature of hemorrhages, the causes of their occurrence must be identified in as soon as possible. Your local physician, as well as more specialized doctors, such as a hematologist, endocrinologist, dermatologist or infectious disease specialist, will help you deal with this problem.

How is the diagnosis done? Correct diagnosis

A doctor can diagnose you even after an examination. But for a more accurate diagnosis, you will need to take a general blood test and examine it for coagulation (coagulogram). In some cases, the doctor may prescribe a bacteriological blood test, and based on these studies, decide on treatment.

First aid for bleeding

As we have already found out, hemorrhages are the leakage of blood from blood vessels due to their damage. Therefore, the first thing you can do in case of minor hemorrhage is to apply something cold to the injured area, which will help reduce the intensity of the bleeding. Further care should be carried out depending on the type of bleeding.

Venous bleeding can be easily identified by the color of the blood flowing out - it will be dark red burgundy. Such blood will flow slowly but continuously. First aid for injury is to apply a tourniquet below 10-15 cm from the wound and a tight bandage. It is imperative to mark the time of application of the tourniquet by inserting a piece of paper with the time of application marked. If the wound is small, then instead of a tourniquet, you can wrap the wound with a bandage, since the venous vessels have the ability to collapse and self-tighten.

Arterial bleeding

It is different from venous. The blood from such a wound is bright red and will flow like a fountain. It is necessary to immediately apply a tourniquet, since without stopping the bleeding a person can die in just a minute. The tourniquet is applied 10-15 cm above the wound, and a bandage should be placed on the wound. The tourniquet is applied for 1-2 hours. After this time, it must be lowered for 3-5 minutes so that the blood circulates through the limb, otherwise the stagnant blood will accumulate toxins and when the tourniquet is removed, the person risks getting shock and dying.

Concerning capillary bleeding, then they do not pose a serious danger (except for injuries in people suffering from poor blood clotting). In this case, the wound must be treated and bandaged.

You can also use modern hemostatic agents such as Celox and Hemostop to stop such bleeding. The powder granules help clot the blood, creating a jelly-like appearance. But treating such a wound will be more difficult.

Internal bleeding is one of the most severe: here you must definitely go to the hospital. On the spot, you can only apply cold to the sore spot and immediately send the victim to the hospital or call " Ambulance"Before the doctors arrive, the patient should be in a calm position and move as little as possible.

How to get rid of hemorrhages

Treatment of hemorrhage is carried out after a detailed medical examination. When making a diagnosis and prescribing treatment, the doctor must take into account the fact that some forms of the disease are prone to the development of unpleasant complications. That is why each stage of treatment must be carried out under the supervision of a doctor. With complications, inflammatory processes can occur, which in some cases can even lead to death.

In order not to aggravate the problem, you need to immediately contact medical care. And only after the doctor’s final conclusion is treatment prescribed.

Depending on the patient’s condition, the clinical form of hemorrhage and the tendency to complications, the feasibility of drug treatment Problems. For example, for minor ones, drug treatment is often not used. But for large skin hemorrhages, local treatment is used in the form of applying heparin or troxevasin ointment to the affected areas twice a day.

Systemic aseptic inflammation of the microvasculature with predominant damage to the skin, joints, gastrointestinal tract and renal glomeruli. Occurs with symptoms of hemorrhagic or urticarial rash, arthralgia, abdominal pain syndrome, hematuria and renal failure. Diagnosis is based on clinical symptoms, laboratory data (blood test, urine test, coagulogram), examination of the gastrointestinal tract and kidneys. The basis of treatment for vasculitis is therapy with anticoagulants and angioplatelet agents. IN severe cases extracorporeal hemocorrection, glucocorticoid therapy, anti-inflammatory, cytostatic treatment are used.

Complications

Kidney damage is the most persistent syndrome of hemorrhagic vasculitis; it can be complicated by malignant glomerulonephritis and chronic renal failure. In severe cases of allergic purpura, gastrointestinal bleeding occurs, accompanied by bloody vomiting and the presence of blood in the stool, pulmonary hemorrhages, hemorrhages in the substance of the brain (hemorrhagic stroke). Massive blood loss can lead to collapse and anemic coma. Complications of abdominal syndrome are less common and are represented by intussusception, peritonitis, thrombosis of mesenteric vessels, necrosis of part of the small intestine. The highest frequency of deaths is recorded in the fulminant form of hepatitis B.

Diagnostics

Treatment

In the acute phase of hemorrhagic vasculitis, patients must adhere to bed rest and a hypoallergenic diet, limit fluid and salt intake, and avoid taking antibiotics and other medications that may increase sensitization of the body. The main directions of therapy depend on the clinical manifestations, so it is advisable to consider them syndromously:

For any syndromes. The basis of basic therapy for all forms of hepatitis B is the prescription of antiplatelet agents (dipyridamole, pentoxifylline) and fibrinolysis activators (nicotinic acid). Drugs of these groups prevent platelet aggregation, improve microcirculation and interstitial perfusion. Heparin and other anticoagulants are often included in the basic regimen.
For skin syndrome. Therapy involves the use of sulfasalazine and colchicine. The use of prednisolone is still controversial issue among doctors. It may be prescribed in severe cases of hepatitis B. In the absence of effect from corticosteroid therapy, cytostatics are used as reserve drugs.
For articular syndrome. Severe arthralgia is relieved by anti-inflammatory therapy (indomethacin, ibuprofen). Additionally, aminoquinoline derivatives (chloroquine) may be prescribed.
For renal syndrome. Appointed high doses glucocorticoids, cytostatics. It is possible to use ACE inhibitors, angiotensin II receptor antagonists, administer normal human immunoglobulin, perform electrophoresis with nicotinic acid and heparin to the kidney area. In terminal stage of chronic renal failure hemodialysis or kidney transplantation is required.
For abdominal syndrome. Intense pain syndrome is an indication for intravenous administration prednisolone, rheopolyglucin, crystalloids. When surgical complications develop (perforation, intussusception), surgical tactics are used.

The severe course of the disease is an indication for extracorporeal hemocorrection (hemosorption, immunosorption,). Many authors note the ineffectiveness antihistamines in the treatment of hepatitis B. However, their use may be justified in patients with a history of allergies. If the disease is associated with food allergies and the presence of abdominal syndrome, enterosorbents are additionally prescribed.

Forecast and prevention

Mild forms of hemorrhagic vasculitis are prone to spontaneous recovery after the first attack of the disease - their prognosis is favorable. In the fulminant form, death of patients can occur in the first few days from the onset of the disease. Most often this is associated with damage to the vessels of the central nervous system and the occurrence of intracerebral hemorrhage. Another cause of death may be severe renal syndrome, leading to the development of uremia. In order to prevent allergic vasculitis, it is recommended to sanitation of chronic infectious foci ENT organs, deworming for helminthic infestations, avoiding contact with known allergens and uncontrolled use of medications.

Hemorrhagic diseases symptoms and signs. Hemorrhages - what is it? Types, causes and treatment. Subcutaneous hemorrhages. Bruise after injection

Hemorrhages at the injection site

Hemorrhages on the skin

Hemorrhages in the stomach

Expulsive hemorrhage

Intramucosal hemorrhages

Hemorrhages - what is it? Types, causes and treatment. Subcutaneous hemorrhages. Bruise after injection

Causes of hemorrhages

Main symptoms of internal bleeding

Hemorrhages at the injection site. What is this?

Causes of skin hemorrhages

What is the danger of hemorrhage?

Which specialist should I contact?

Carrying out diagnostics

First aid for bleeding

Arterial bleeding

How to get rid of hemorrhages?

Hemorrhage: causes, symptoms, treatment

Causes

Symptoms

Diagnostics

Treatment

Hemorrhagic syndrome - types and causes. Symptoms and consequences of hemorrhagic syndrome in children and adults

What are hemorrhages

Hemorrhagic syndrome is typical for what diseases?

Note!

Hemorrhagic diathesis in children

Pathogenesis of hemorrhagic syndrome

Hemorrhagic diseases - classification

Symptoms of hemorrhagic syndrome

Treatment of hemorrhagic syndrome

Consequences of hemorrhagic disease

Prevention of hemorrhagic syndrome

Hemorrhagic syndrome: symptoms and treatment

Hemorrhagic syndrome - main symptoms:

Causes

Varieties

Symptoms

Diagnosis and treatment

Hemorrhagic syndrome, treatment

Causes of hemorrhagic syndrome

Symptoms and signs of hemorrhagic syndrome

Stages of diagnostic search

Differential diagnosis of hemorrhagic syndrome

Hemorrhage

Causes of hemorrhage

Symptoms of hemorrhage

Treatment of hemorrhage

Reasons for the development of pathology

Classification and main features

Diagnostic tests

Therapeutic measures

Urgent Care

Drugs

Home Recipes

Causes

Classification

Clinical manifestations

Symptoms of hemorrhagic vasculitis

Differences in symptoms between children and adults

Hemorrhagic vasculitis: photo

Complications

Diagnostics

Treatment of hemorrhagic vasculitis

Diet

Which doctor should I contact?

Forecast

Why do hemorrhages occur?

Types of hemorrhage by causes

Types of hemorrhage by location

Main symptoms of internal bleeding

Hemorrhages at the injection site. What is this?

Why do skin hemorrhages occur?

Why are hemorrhages dangerous?

Which doctor should I go to?

How is the diagnosis done? Correct diagnosis

First aid for bleeding

Arterial bleeding

How to get rid of hemorrhages

Complications