Symptoms and Signs of Internal Bleeding

Doctor's Notes on Internal Bleeding

Internal bleeding is when blood vessels within the body are damaged and/or torn so that blood leaks out of any of the blood vessels. The symptoms of internal bleeding vary depending upon what part of the body is involved or what organ system is damaged and how much blood is lost into tissues or other areas. For example, shock (rapid heartbeat, low blood pressure, cool and sweaty skin, and mental status changes) may occur if large amounts of blood are lost. Large amounts of blood may be lost during pregnancy or at the time of delivery.

• Blood outside of vessels is irritating and may cause pain and inflammation;
• blood in the peritoneum may cause intense pain,
• blood that irritates the diaphragm may cause chest pain,
• blood in the brain can cause stroke symptoms including vomiting, seizures, loss of vision, and weakness or death.

Bleeding in the kidney or bladder may result in blood in the urine; similarly, bleeding in the G.I. tract may produce blood in the stools or black tarry stools.

The causes of internal bleeding are numerous. Anything that damages, weakens, rips, or cuts blood vessels (trauma) can be a cause. Examples of such agents are 

• high blood pressure,
• aneurysms,
• medications like warfarin,
• accidents (compression and/or deceleration injuries), 
• bleeding disorders, 
• liver failure (clotting factors not adequate), 
• ectopic pregnancy, 
• vaginal bleeding,
• surgical bleeding, and/or
• combinations of causes.

What are the treatments for internal bleeding?

The treatments for internal bleeding depend on its cause and severity. For example, treating mild to moderate bleeding involves mainly rest and hydration to allow clot formation that stops bleeding. Some moderate to severe internal bleeding usually needs intervention to augment the clotting process and/or to physically close up or remove the bleeding site. For example, clot formation may be enhanced by:

• IV fluids containing 
  • Blood or plasma
  • Platelets
  • Vitamin K
  • Electrolytes
  • Other chemical compounds

The above may be included with surgery when moderate and/or severe internal bleeding is likely to need physical intervention. For example:

• Surgical interventions
  • Surgical repair of severed, torn, or ruptured blood vessels
  • Repair or removal of a foreign body (bullet, knife blade)
  • Repair or removal of part or all of a compromised organ or system (GI tract segment, ectopic pregnancy, for example)

Severe internal bleeding is a medical emergency, call 911.