Haematoma is a medical condition that is generally defined as the pooling of blood outside of blood vessels beneath the skin. Haematomas are classified into different types based on the body part they affect and one such type is subcutaneous haematoma. It is a very common condition and can be easily seen under the skin as bluish bruises and sometimes it is deep inside the body and is not visible. Skin discolouration and sometimes swelling and pain are some of its symptoms and it is mostly benign but can become a serious condition if left untreated and can lead to issues like necrosis or infection. A subcutaneous haematoma can indicate a trauma or a drug induced cause or more importantly a Bleeding Diathesis. Understanding its causes, symptoms and management is essential for timely care. Connect with Neotia Getwel Multispecialty Hospital which offers the best medical assistance and 24/7 emergency care.

Subcutaneous Haematoma: An Overview

Subcutaneous Haematoma occurs just under the skin affecting the shallow veins close to the surface. It is usually caused by a trauma or injury to the wall of blood vessels, resulting in a rupture in the blood vessel that allows blood to leak out and spread into the surrounding tissue. This results in discolouration (may appear as reddish or purplish or bluish or bluish black or greenish), swelling and pain around the affected region.

Subcutaneous haematoma differs from common bruises even though they both occur due to rupture in the blood vessel. One of the most common differences between a bruise and a subcutaneous haematoma lies in their appearance. In subcutaneous haematoma a lump or solid mass is raised around the affected area that feels tender and spongy, on the other hand a bruise is rather flat and firm. The healing time of a bruise is also short and can heal on its own within a week or two, while subcutaneous haematoma can take a longer period if it has active bleeding.

Causes and Symptoms of Subcutaneous Haematoma

The most common causes and symptoms include:

Causes

• Falls, bumps and hard blows can damage the walls of blood vessels leading to blood pooling in tissue. Sports injuries and accidents are the major reasons behind subcutaneous haematoma formation.
• Certain blood-thinning medications like aspirin and warfarin, increase the risk of subcutaneous haematoma by reducing the ability of blood to clot.
• Excess bleeding during or after a surgical procedure can also put someone at a high risk of developing a subcutaneous haematoma.
• Subcutaneous haematoma can affect older people easily due to their thin skin and fragile blood vessels. If they fall or meet with an accident then their blood vessels are more prone to rupture, leading to the formation of a haematoma.
• Acquired or congenital platelet dysfunction.
• Congenital bleeding disorders like haemophilia, Von Willebrand disease etc.
• Acquired coagulopathies like in liver diseases, severe blood loss.
• Several Diseases like neurofibromatosis (a genetic disorder that can cause severe bleeding due to even a minor injury.

Symptoms

• Swelling: Swelling at the site of injury or trauma is a common symptom of subcutaneous haematoma.
• Discolouration: Subcutaneous haematoma can be of different colours such as red, purple, blue, or green, depending on the time it has occurred.
• Pain: Pain is another common symptom of subcutaneous haematoma, one can feel tender pain at the affected site.
• Local warmth: Sometimes the hematoma area can feel warm due to local inflammatory reactions.

Diagnostic Aids

• Ultrasound: This is Used to confirm the hematoma, determine the size of hematoma and sometimes to rule out other conditions like tissue abscess or thrombotic lesion.
• CT/MRI: It is used in case hematoma is too deep seated or too large in size.

Management and Treatment

Management and treatment of subcutaneous haematoma can depend on its size, affected body part and patient’s health condition. Most subcutaneous haematomas can heal on their own but proper management and treatment can reduce the chance of further complications caused by them. For subcutaneous haematoma treatment, conservative approach is done for minor cases and invasive interventions for more severe and complicated cases .

Conservative Approach:

Rest: Rest the affected site.

Ice: Apply an ice pack on the affected site intermittently (10 to 15 minutes per application) within the first 48hours. Do not apply warm fomentation or hot bags.

Compression: Using a wrap or elastic bandage on the injured area can reduce further bleeding by applying gentle pressure.

Elevation: Keeping the affected area raised or elevated can reduce the blood flow to the ruptured blood vessel, minimizing swelling.

Invasive Options:

Needle Aspiration: For treating large subcutaneous haematoma a minor surgical procedure is carried out by a doctor in which a needle is used to drain out the blood.

Incision and Drainage: This is done in cases where needle aspiration is inadequate or if hematoma is infected and needs thorough irrigation.

Excision/Resection: Sometimes surgical excision is required to remove clot material and/or necrotic tissue especially if the hematoma is chronic or of organised nature.

Physical Therapy: Some physical therapies are also one of the ways of treating subcutaneous haematoma, they help with restoring the strength of affected tissue.

Novel Therapies

Cryotherapy: to limit hematoma size and promote healing.

Hyperbaric Oxygen Therapy: to reduce inflammation and promote healing.

Stem cell therapy/Regenerative Medicine: use of patients own stem cells for regenerating tissuesand improving recovery in severe hematomas.

Pharmacological interventions: using antifibrinolytics like tranexamic acid to limit the volume of hematoma and promote healing.

Conclusion

Subcutaneous haematoma is generally a common medical condition, different from a common bruise and caused by multiple reasons such as trauma or injury, complications during surgery, or anticoagulant medicines that disrupt the clotting property of blood. Subcutaneous haematomas are mostly harmless but they can cause discomfort and can lead to further complications if they are not managed or treated well. Understanding its various symptoms and causes can help in effective care by following various management and treatment. Connect with Neotia Getwel Multispecialty Hospital which offers the best medical assistance and 24/7 emergency care.

Disclaimer

Though all attempts are made to provide correct information on the subject, inadvertent & typographical errors arising out of manual intervention cannot be ruled out. Any such discrepancies should be brought to the blogger's notice for correction.