Hematoma

ExitCare ImageA hematoma is a collection of blood under the skin, in an organ, in a body space, in a joint space, or in other tissue. The blood can clot to form a lump that you can see and feel. The lump is often firm and may sometimes become sore and tender. Most hematomas get better in a few days to weeks. However, some hematomas may be serious and require medical care. Hematomas can range in size from very small to very large.

CAUSES

A hematoma can be caused by a blunt or penetrating injury. It can also be caused by spontaneous leakage from a blood vessel under the skin. Spontaneous leakage from a blood vessel is more likely to occur in older people, especially those taking blood thinners. Sometimes, a hematoma can develop after certain medical procedures.

SIGNS AND SYMPTOMS

  • A firm lump on the body.

  • Possible pain and tenderness in the area.

  • Bruising. Blue, dark blue, purple-red, or yellowish skin may appear at the site of the hematoma if the hematoma is close to the surface of the skin.

For hematomas in deeper tissues or body spaces, the signs and symptoms may be subtle. For example, an intra-abdominal hematoma may cause abdominal pain, weakness, fainting, and shortness of breath. An intracranial hematoma may cause a headache or symptoms such as weakness, trouble speaking, or a change in consciousness.

DIAGNOSIS

A hematoma can usually be diagnosed based on your medical history and a physical exam. Imaging tests may be needed if your health care provider suspects a hematoma in deeper tissues or body spaces, such as the abdomen, head, or chest. These tests may include ultrasonography or a CT scan.

TREATMENT

Hematomas usually go away on their own over time. Rarely does the blood need to be drained out of the body. Large hematomas or those that may affect vital organs will sometimes need surgical drainage or monitoring.

HOME CARE INSTRUCTIONS

  • Apply ice to the injured area:  

  • Put ice in a plastic bag.  

  • Place a towel between your skin and the bag.  

  • Leave the ice on for 20 minutes, 2–3 times a day for the first 1 to 2 days.  

  • After the first 2 days, switch to using warm compresses on the hematoma.  

  • Elevate the injured area to help decrease pain and swelling. Wrapping the area with an elastic bandage may also be helpful. Compression helps to reduce swelling and promotes shrinking of the hematoma. Make sure the bandage is not wrapped too tight.  

  • If your hematoma is on a lower extremity and is painful, crutches may be helpful for a couple days.  

  • Only take over-the-counter or prescription medicines as directed by your health care provider.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have increasing pain, or your pain is not controlled with medicine.  

  • You have a fever.  

  • You have worsening swelling or discoloration.  

  • Your skin over the hematoma breaks or starts bleeding.  

  • Your hematoma is in your chest or abdomen and you have weakness, shortness of breath, or a change in consciousness.

  • Your hematoma is on your scalp (caused by a fall or injury) and you have a worsening headache or a change in alertness or consciousness.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.