Bruise
From Wikipedia, the free encyclopedia
| ICD-10 | S00 - S90 |
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A bruise or contusion or ecchymosis is a kind of injury, usually caused by blunt impact, in which the capillaries are damaged, allowing blood to seep into the surrounding tissue. They often induce pain but are not normally dangerous. Sometimes, however, bruises can be serious, leading to other more life threatening forms of hematoma, or can be associated with serious injuries, including fractures and internal bleeding. Minor bruises are easily recognized by their characteristic blue or purple color in the days following the injury.
The word "bruise" is also used for fruit — a fruit is considered bruised when an impact breaks its internal water-containing structures, leading to a soft spot. More generally, "bruise" is used metaphorically to mean any minor injury: one's ego might be "bruised" if one's painting was not included in a gallery showing, for example. The implication is that the injury is painful but minor and will recover on its own.
The presence of bruises may be seen in patients with platelet or coagulation disorders. Unexplained bruising may be a warning sign of child abuse or serious medical problems, such as leukemia and meningoccocal infection. Anybody with unexplained bruising needs urgent examination by a doctor.
The extent of bruising depends on many factors. The state of the tissue (tensed muscle versus relaxed muscle, for example) can make a large difference, as can the effect of being crushed against underlying bone. People also vary in the sturdiness of their capillaries — some people bruise more easily than others. A deficiency in Vitamin C can make a person more susceptible to bruises.
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[edit] Light bruises
When stricken, the victim normally feels some pain, although it may not be sharp and may even go unnoticed. The flesh quickly becomes red, tender, and swollen (this, like other effects, varies with the intensity of the bruising). Repeated impacts aggravate the bruising. Over the course of a day, blood seeps into the surrounding tissue while the capillaries are being repaired. The bruise gradually darkens. Over the course of a week or two, the bruise darkens to a livid red, then fades to purple, black, or blue, eventually fading to yellow and disappearing as healing progresses. Normal, light bruises heal completely in a week or two; more severe or deeper bruises may take longer. The striking colors of a bruise are due to hemoglobin and its breakdown products, bilirubin and biliverdin.
The treatment for light bruises is minimal. If swelling is severe, it might be reduced by applying ice or by elevating the affected area. Avoiding re-injury is essential to quick recovery, so rest is probably called for; usually the pain of having a bruise bumped is a sufficient reminder. According to WebMD, one should "gently massage or rub the area to relieve pain and encourage blood flow. Do not massage the bruised area if it causes pain."
[edit] Severe bruises
If bruising is severe, complications may arise. Excess fluid may accumulate, forming a hard lump called a hematoma. Swelling may also be severe, and pain may be a serious problem. If internal bleeding inside the tissue is very severe, compartment syndrome may occur, leading to disrupted blood flow due to swelling; this can require surgery. More seriously, the impacts that cause severe bruising can also cause other damage: impacts to the torso may damage internal organs, and impacts to the head can be very dangerous. Bones may be broken by similar impacts, and joints can be sprained or otherwise damaged as well. The symptoms of these injuries may appear to be those of simple bruising; if there is any possibility of one of these more severe injuries (difficulty moving an injured limb, severe abdominal bruising or a feeling of liquid under the skin) see a doctor immediately.
Treatments for severe bruising can include RICE: Rest, Ice, Compression bandages and Elevation, as well as painkillers (particularly NSAIDs). Massaging severe bruises will worsen the injury. Later in recovery, some light stretching exercises may be appropriate, but it is probably best to consult a doctor or physiotherapist about longer-term recovery. If a severely bruised muscle is used too early in the recovery process, bone tissue may be formed inside the muscle, leading to lasting stiffness and pain. Severe bruises can be expected to take longer to heal.
