Method for stopping parenchymal bleeding test. What is parenchymal bleeding and how to stop it

Parenchymal bleeding is the process of hemorrhage into the body cavity, that is, internal. This phenomenon can provoke mechanical damage or some forms of disease. This condition can be dangerous to human life and health. If there is severe internal bleeding, such as after a car accident, a person should surgical intervention that will help save lives.

General characteristics of internal bleeding

Such bleeding occurs when tissue is injured internal organs. Diagnosis of this condition is usually very difficult.

Most often bleeding occurs:

• due to mechanical damage;
• as a result of neoplasms;
• due to serious illness.

Symptoms may be hidden or mild, so if you suspect the development of such a process, you should immediately contact a specialist. The medical institution will conduct full examination, which will allow us to identify the cause and make predictions.

Fatal blood loss is approximately 2.5 liters for an adult. In this case, a blood transfusion is performed to save the person's life. Transfusions are performed during surgery and for several days after it. As a result of large blood loss, a slow heartbeat, a decrease in red blood cells and other important substances that make up the blood are observed.

The general condition of a person worsens, severe pain. The metabolic process is disrupted, the body begins to suffer and experience severe stress. If you have such a problem, you should immediately seek medical help.

Which organs may suffer from this problem?

Parenchymal bleeding usually occurs in the following organs:

• liver;
• kidneys;
• lungs;
• spleen.

The peculiarity of these organs is that they consist of thick and blood-supplied parenchyma. This is due to the fact that the main functions of the organs are to filter substances that the body does not need.

This type of bleeding can occur:

• due to mechanical damage in which tissue ruptures occurred;
• due to organ disease, especially due to the appearance of tumors;
• due to infectious lesions;
• as a result of cancer.

Poor blood clotting can worsen the situation. Patients who suffer from poor blood clotting are at risk, since hemorrhage can occur not only from mechanical damage, but at any time.

In this case, the blood loss may be insignificant and not cause any particular harm to the patient’s health; in another case, the bleeding may be so severe that it will be impossible to stop it without emergency surgery. As a result of this phenomenon, a sharp decline the content of red blood cells and iron in the blood, which leads to oxygen starvation.

If there is heavy bleeding, the patient may experience hemorrhagic shock. Rapid blood loss leads to cardiac arrest and death.

Danger condition

Parenchymal bleeding is a life-threatening and health-threatening condition. With this phenomenon, blood flows into the surrounding tissue, organ cavity, body cavity.

Based on the type of bleeding, they are divided into the following types:

• venous;
• capillary;
• arterial

The first type is formed when the liver is injured and is distinguished by characteristic clinical manifestations that begin to develop quite quickly. With this type of hemorrhage, there is a high probability of developing hemorrhagic shock.

The capillary type develops rather slowly, so its onset is often missed. Blood flows out in small portions, which leads to a sharp decrease in iron and red blood cells in the body. In addition, it is developing inflammatory process V abdominal cavity.

The danger of the condition lies in the fact that the parenchymal organs are not capable of stopping the bleeding on their own, which requires surgical intervention. The inability of organs to ensure the process of stopping blood is due to their structure and the absence of spasm of blood vessels passing inside their tissues.

This condition causes irreversible consequences in the patient's body. The person feels unwell, weak and dizzy. If blood loss is not stopped in a timely manner, the body will die.

Clinical manifestations of the disease

Such bleeding, which develops quite quickly, immediately makes itself known. However, if the bleeding is slow, then clinical manifestations may be absent or completely invisible.

Symptoms of this condition include:

• severe and rapid fatigue;
• dizziness;
• constant desire to drink;
• pallor skin;
• chills;
• pressure drop.

In addition, there are special clinical manifestations that occur depending on the affected organ.

Particular attention should be paid to the following conditions:

• expectoration of blood;
• acute pain in the abdominal cavity;
• change in urine color;
• the appearance of pressure in the chest area;
• dyspnea.

The appearance of bleeding in the lungs often occurs when ribs are fractured, when sharp bones pierce the tissues of the respiratory organs. And also the lesion can be caused by tuberculosis or oncology.

The spleen most often ruptures due to mechanical trauma (for example, as a result of an accident). In this case, immediate surgical intervention is required; any delay may cost the patient’s life.

The kidneys are susceptible to injury when tumors are compressed or ruptured. In this condition, the urine becomes sharply colored and severe pain is observed.

In any case, the condition requires immediate intervention from specialists. If symptoms of internal bleeding are observed, call immediately ambulance.

First aid and surgery

First of all, you should pay attention to the following manifestations:

• presence of abdominal injuries;
• mechanical damage chest;
• formation of hematomas and bruises;
• sharp pain in the area of ​​the damaged organ;
• sweat;
• chills and fever;
• cardiopalmus;
• a sharp decrease in pressure.

If you suspect the development of such a condition, the patient should be taken to the hospital as soon as possible, since it is impossible to stop such a process outside the hospital.

Before the doctors arrive, you must:

1. Lay the patient down and elevate the legs.
2. Cool the suspected area of ​​damage.

When the ambulance arrives, specialists will transport the victim to the hospital and administer medications such as:

• Etamsylate;
• Vikasol;
• Aminocaproic acid.

Medicines will not stop the bleeding, but will improve the patient's condition. In order to maintain pressure, specialists will begin to administer a special solution intravenously.

Once the patient is admitted to the hospital, he will immediately be taken to the operating room where emergency procedures will be performed.

Before performing a surgical intervention, the following measures will be carried out:

1. General tests.
2. Ultrasound ( ultrasonography).
3. X-ray.

If all tests are within normal limits, then doctors will conduct emergency surgery. Otherwise, diagnostic laparoscopy is performed.

There are several ways to stop such hemorrhage, among them are:

• drying with a special sponge;
• hemming of the omentum;
• amputation of the affected part;
• electrocoagulation;
• sewing using special seams.

During the operation, a blood transfusion is performed, and this procedure is also done several times during the recovery process. In addition, saline solution is infused and maintenance therapy is carried out aimed at preventing the development of DIC syndrome (disseminated intravascular coagulation) and multiple organ failure.

Such bleeding usually becomes a threat to the patient’s life, so it cannot be delayed. The sooner it is carried out surgery, the better the outcome will be. With successful surgery, the patient's life can be saved.

Contacting a medical facility

As soon as the victim is delivered to a medical facility, specialists will begin to carry out the following activities:

• Assess the patient for blunt or sharp trauma.
• Check for the development of an infectious disease.
• Taking tests for oncology.
• External examination and palpation.
• Measurement of such basic parameters as pulse, pressure, temperature.

After surgical intervention is performed (a method of stopping parenchymal bleeding), the patient will have to long-term treatment in a hospital setting. Even surgical procedures cannot always stop the development of this process. This is due to the fact that the organs have a specific structure with a very “delicate” structure.

During the recovery process, the patient is constantly transfused with blood, plasma and platelet mass. If the organ cannot be sutured, then amputation is performed - complete or partial. The task of specialists is to prevent the patient from experiencing shock from large blood loss. To do this, a procedure is carried out to restore circulation.

Especially dangerous options are considered to be those when internal hemorrhage of a mixed type occurs. In this case, the lack of medical care leads to the death of a person.

- is an outpouring of blood external environment, natural body cavities, organs and tissues. The clinical significance of the pathology depends on the magnitude and rate of blood loss. Symptoms: weakness, dizziness, pallor, tachycardia, decreased blood pressure, fainting. Detection of external bleeding is not difficult, since the source is visible to the naked eye. To diagnose internal bleeding, depending on the location, various instrumental techniques can be used: puncture, laparoscopy, X-ray contrast study, endoscopy, etc. Treatment is usually surgical.

ICD-10

R58 Bleeding not elsewhere classified

General information

Bleeding – pathological condition, in which blood from the vessels is poured into the external environment or into the internal organs, tissues and natural cavities of the body. Is a condition that requires emergency medical attention. The loss of a significant volume of blood, especially within a short time, poses an immediate threat to the patient’s life and can cause fatal outcome. Treatment of bleeding, depending on the cause of its occurrence, can be carried out by orthopedic traumatologists, abdominal surgeons, thoracic surgeons, neurosurgeons, urologists, hematologists and some other specialists.

Classification

Taking into account the place into which the blood flows, the following types of bleeding are distinguished:

• External bleeding - into the external environment. There is a visible source in the form of a wound, open fracture or crushed soft tissue.
• Internal bleeding - into one of the natural body cavities communicating with the external environment: bladder, lung, stomach, intestines.
• Hidden bleeding– in tissues or body cavities that do not communicate with the external environment: in the interfascial space, ventricles of the brain, joint cavity, abdominal, pericardial or pleural cavities.

As a rule, in clinical practice hidden bleeding is also called internal, however, taking into account the characteristics of pathogenesis, symptoms, diagnosis and treatment, they are separated into a separate subgroup.

Depending on the type of damaged vessel, the following types of bleeding are distinguished:

• Arterial bleeding. Occurs when the artery wall is damaged. Is different high speed blood loss poses a danger to life. The blood is bright scarlet and flows out in a tense, pulsating stream.
• Venous bleeding. Develops when the vein wall is damaged. The rate of blood loss is lower than when an artery of similar diameter is damaged. The blood is dark, with a cherry tint, flows in an even stream, and there is usually no pulsation. If large venous trunks are damaged, pulsation in the rhythm of breathing may be observed.
• Capillary bleeding. Occurs when capillaries are damaged. Blood is released in separate drops resembling dew or condensation (symptom of “blood dew”).
• Parenchymal bleeding. Develops when parenchymal organs (spleen, liver, kidneys, lungs, pancreas), cavernous tissue and cancellous bone are damaged. Due to the structural features of these organs and tissues, damaged vessels are not compressed by the surrounding tissue and do not contract, which causes significant difficulties in stopping bleeding.
• Mixed bleeding. Occurs when veins and arteries are simultaneously damaged. The cause, as a rule, is injury to parenchymal organs that have a developed arterial-venous network.

Depending on the severity, bleeding can be:

• Lungs (loss of no more than 500 ml of blood or 10-15% of blood volume).
• Average (loss of 500-1000 ml or 16-20% of bcc).
• Severe (loss of 1-1.5 liters or 21-30% of bcc).
• Massive (loss of more than 1.5 liters or more than 30% of the bcc).
• Fatal (loss of 2.5-3 liters or 50-60% of blood volume).
• Absolutely fatal (loss of 3-3.5 liters or more than 60% of the blood volume).

Taking into account the origin, traumatic bleeding is distinguished, which develops as a result of injury to unchanged organs and tissues, and pathological bleeding, which occurs as a result pathological process in any organ or are a consequence of increased permeability of the vascular wall.

Depending on the time of occurrence, specialists in the field of traumatology and orthopedics distinguish between primary, early secondary and late secondary bleeding. Primary bleeding develops immediately after injury, early secondary bleeding occurs during or after surgery (for example, as a result of a ligature slipping from the wall of a vessel), and late secondary bleeding occurs after several days or weeks. The cause of late secondary bleeding is suppuration followed by melting of the vessel wall.

Symptoms of bleeding

To the number common features pathologies include dizziness, weakness, shortness of breath, extreme thirst, pallor of the skin and mucous membranes, decreased blood pressure, increased heart rate (tachycardia), pre-syncope and fainting. The severity and rate of development of these symptoms is determined by the rate of bleeding. Acute blood loss is more difficult to tolerate than chronic blood loss, since in the latter case the body has time to partially “adapt” to the changes taking place.

Local changes depend on the characteristics of the injury or pathological process and the type of bleeding. With external bleeding, there is a violation of the integrity of the skin. When bleeding from the stomach occurs, melena (tarry black loose stool) and vomiting changes dark blood. With esophageal bleeding, bloody vomiting is also possible, but the blood is brighter, red, rather than dark. Bleeding from the intestines is accompanied by melena, but the characteristic dark vomiting is absent. If the lung is damaged, bright scarlet, light foaming blood is coughed up. For bleeding from renal pelvis or bladder is characterized by hematuria.

Hidden bleeding is the most dangerous and most difficult to diagnose; they can only be identified by indirect signs. At the same time, the blood accumulating in the cavities compresses the internal organs, disrupting their functioning, which in some cases can cause the development of dangerous complications and death of the patient. Hemothorax is accompanied by difficulty breathing, shortness of breath and weakening of percussion sound in the lower parts of the chest (with adhesions in pleural cavity possible dullness in the upper or middle sections). With hemopericardium, due to compression of the myocardium, cardiac activity is disrupted, and cardiac arrest is possible. Bleeding into the abdominal cavity is manifested by bloating of the abdomen and dullness of percussion sound in its sloping sections. When bleeding into the cranial cavity, neurological disorders occur.

Bleeding out of bounds vascular bed has a pronounced Negative influence for the whole body. Due to bleeding, the blood volume decreases. As a result, cardiac activity deteriorates, organs and tissues receive less oxygen. With prolonged or extensive blood loss, anemia develops. The loss of a significant volume of bcc over a short period of time causes traumatic and hypovolemic shock. Shock lung develops, volume decreases renal filtration, oliguria or anuria occurs. Foci of necrosis form in the liver, and parenchymal jaundice is possible.

Types of bleeding

Bleeding from wounds

First aid consists of anesthesia and immobilization with a splint. At open fractures A sterile bandage is applied to the wound. The patient is taken to the emergency room or trauma department. To clarify the diagnosis, radiography of the damaged segment is prescribed. For open fractures, PSO is performed; otherwise, treatment tactics depend on the type and location of the injury. For intra-articular fractures accompanied by hemarthrosis, a joint puncture is performed. In case of traumatic shock, appropriate anti-shock measures are taken.

Bleeding from other injuries

TBI can be complicated by hidden bleeding and hematoma formation in the cranial cavity. At the same time, a fracture of the skull bones is not always observed, and patients in the first hours after the injury may feel satisfactory, which complicates the diagnosis. With closed rib fractures, damage to the pleura is sometimes observed, accompanied by internal bleeding and the formation of hemothorax. With blunt trauma to the abdominal cavity, bleeding from the damaged liver, spleen or hollow organs (stomach, intestines) is possible. Bleeding from parenchymal organs is especially dangerous due to the massive blood loss. Such injuries are characterized by the rapid development of shock; without immediate qualified assistance, death usually occurs.

In case of injuries to the lumbar region, a bruise or rupture of the kidney is possible. In the first case, the blood loss is insignificant; bleeding is evidenced by the appearance of blood in the urine; in the second case, there is a picture of rapidly increasing blood loss, accompanied by pain in the lumbar region. With bruises in the lower abdomen, rupture of the urethra and bladder may occur.

First aid for all internal bleeding of a traumatic nature consists of pain relief, ensuring rest and immediate delivery of the patient to a specialized medical facility. institution. The patient is placed in horizontal position with raised legs. Apply cold (blister or heating pad with ice or cold water). If esophageal or gastric bleeding is suspected, the patient is not allowed to eat or drink.

On prehospital stage If possible, carry out anti-shock measures and replenish the blood volume. Upon admission to medical school. establishment continues infusion therapy. The list of diagnostic measures depends on the nature of the injury. In case of TBI, a consultation with a neurosurgeon, skull X-ray and EchoEG are prescribed, in case of hemothorax - chest X-ray, in case of

Depending on the morphological structure of the damaged vessel and the nature of the outpouring of blood, capillary, venous, arterial and parenchymal bleeding are distinguished.

Capillary bleeding occurs when the smallest terminal branches of blood vessels - capillaries - are damaged. It occurs most often with wounds to the skin, muscle tissue and bruises. In cases open damage blood appears on the surface of the wound in drops that merge with each other and flow out or remain in the wound; With bruises, small hemorrhages form in the damaged tissues.

Capillary bleeding usually stops on its own or after short-term tamponade of the wound, or after applying a lightly compressive bandage. It can be very long and abundant only in cases of reduced blood clotting, insufficient liver function and hemophilia.

Vein bleeding observed in wounds venous vessels and is easily recognized by the dark red blood flowing in a continuous stream from the peripheral end of the damaged vessel. The blood stream does not flow like a fountain. It pulsates only in cases where the cut vein is adjacent directly to a large artery, or as a result breathing movements chest when bleeding large vein located close to the heart.

During expiration, venous bleeding increases, and during inspiration, due to the suction effect of the chest, it decreases. Negative venous pressure resulting from deep inspiration can cause air embolism. Increased venous pressure increases bleeding from the damaged vein. Therefore, operations for heart diseases accompanied by stagnation of blood in the veins, operations on a lowered head or on the limbs under a loose tourniquet are accompanied by severe venous bleeding.

The outcome of venous bleeding varies. In case of damage to deep-lying large veins (cava, femoral, iliac, portal, etc.), bleeding is usually fatal due to rapid and enormous blood loss.

With injuries to small veins, bleeding does not pose a serious danger. It stops on its own or can be easily stopped by wound tamponade, pressure bandage.

Arterial bleeding caused by damage arterial vessel. High pressure V arterial system, the abundant oxygen content in the blood itself, a large number of elastic fibers in the artery wall determine the specific character arterial bleeding. The blood has a scarlet, bright red color. It flows from the cut artery in a fountain or pulsating stream. With an abundance of collaterals, the central and peripheral ends of the cut vessel bleed; however, bleeding from the peripheral end is weaker. Therefore, bleeding has long been stopped primarily from the end of the vessel lying between the wound and the heart.

Bleeding from large arteries causes the animal to quickly die if immediate help is not provided. For example, when cutting carotid artery horses die, according to some sources, after 10-15 minutes, according to others - after 45-55 minutes.

Hemodynamic disorders resulting from heavy blood loss cause the development severe consequences to a greater extent than the blood loss itself. S.I. Spasokukotsky back in 1935 paid attention “not to the amount of blood loss, but to the degree of decompensation of the circulatory process.”

Parenchymal bleeding observed with injury to parenchymal organs, spongy bones and cavernous tissue. Blood flows from the smallest arteries and veins from the entire surface of the wound, like water from a sponge.

Parenchymal bleeding is essentially mixed, but since bleeding from numerous veins predominates, the flowing blood resembles venous blood in color. Cut vessels in parenchymal organs do not contract, do not go deep into the tissue and are not compressed by the tissue itself, so the bleeding is very profuse and often life-threatening for the patient.

The same type of bleeding develops after prolonged or excessive constriction of a limb with a tourniquet. In this case, bleeding occurs due to paralysis of vasoconstrictors; that's why they call him atonic, or paralytic, bleeding.

Parenchymal bleeding is most often stopped by simple tamponade, a pressure bandage, the application of compression sutures, or the use of tissue tamponade.

External and internal bleeding

Depending on the location of the bleeding, bleeding can be external or internal.

With external, or open, bleeding, blood flows from a wound or natural opening into the external environment, and therefore it is not difficult to recognize it. With internal, or closed, bleeding, blood does not appear outside; it accumulates in tissues or anatomical cavities (pleura, peritoneum, joint, skull, etc.); Therefore, it is customary to distinguish between interstitial and intracavitary bleeding.

Bleeding is called combined if blood flows out and simultaneously penetrates into any cavity, for example, the pleural cavity when the intercostal artery is injured. Combined is bleeding from the nose (epistaxis), bleeding in the urine (haematuiia), etc.

Interstitial bleeding, depending on the caliber of the damaged vessel, anatomical structure tissues and the amount of loose fiber are very diverse. So, they distinguish: ecchymoses- pinpoint hemorrhages; potechia- small, sharply limited hemorrhages in the form of spots; sugillation- flat, small-space bruises with indefinite boundaries; suffusion- extensive bruises that occur when capillaries and small vessels are injured and, finally, hematomas when arterial or venous trunks or their large branches are damaged.

Intracavitary bleeding is characterized, as we have already indicated, by the effusion of blood into anatomical cavities, from which hemorrhages receive their corresponding names. For example, hemorrhages in a joint are called haemarthrosis; into the cavity of the spinal canal - haomatorachis; into the peritoneal cavity - haematoperitoneum; in the chest cavity - haemothorax; into the uterus - haematometra; in the eye - haemophthalmus, etc.

General symptoms internal bleeding is expressed by weakness, a drop in pulse and anemia of the visible mucous membranes. Bleeding into hollow organs (bladder, stomach, intestines) is recognized by the release of blood in the urine, bloody vomiting, the presence of blood in feces. With hemorrhage into anatomical cavities, for example, into the pleural cavity, there is progressive shortness of breath, dullness of percussion sound and weakening alveolar breathing. Excessive interstitial hemorrhages sometimes cause hemoglobinuria.

Belly in human body– the most unprotected area, injuries and blows are common here, especially in adolescence. Most of them do not pose a threat and do not require emergency medical intervention, but some have quite serious consequences. Injuries to internal organs with damage to the blood vessels are one of the common causes of hospitalization. If parenchymal bleeding occurs during a wound and is not noticed and stopped in time, it carries the threat of complications, including death.

What are parenchymal organs? These are organs, most of which do not have a cavity, the main tissue of which is abundantly supplied with mesh. Parenchymal organs in humans are involved in vital processes in the body: ensuring respiration, tissue nutrition, and cleaning.

This group includes:

• lungs– the main supplier of oxygen and utilizer of carbon dioxide, lung tissue ensures gas exchange through a network of small capillaries and alveoli;
• liver– a “factory” for purifying the blood from toxins formed during the breakdown of substances; in addition, it is involved in the production of certain enzymes;
• spleen- an important hematopoietic organ along with bone marrow, is a storage place for young maturing cells and a place for disposal of cells that have spent their life;
• pancreas – main body, producing insulin;
• The kidneys regulate the process of excretion of fluid and dissolved waste products.

The main tissue of parenchymal organs has a rich blood supply, and even the slightest injury can cause massive damage.

Why are they dangerous?

With internal bleeding, an outpouring of blood occurs: into the surrounding tissue, into the organ cavity, into the free cavity (pleural, abdominal, pelvic). According to the affected vessel, there are: arterial, venous, and capillary bleeding. For example, venous bleeding can occur when injured portal vein liver, is characterized by a rapid increase in symptoms, massive blood loss, and the likelihood of developing hemorrhagic shock.

Reasons for development

• According to statistics, the main cause of vascular damage is injury.
• , causing tissue damage, such as tuberculosis.
• Malignant neoplasms in last stage cause bleeding when the tumor disintegrates.
• Benign neoplasms, in case of their rupture.

For each parenchymal organ there are its own most common reasons, signs and characteristics of the development of bleeding.

The lungs are often injured by the sharp edges of the ribs when they are fractured. Therefore, if a rib fracture is suspected, tight bandaging is strictly contraindicated. Bleeding due to tuberculosis and cancer is also a common cause. The main symptoms of bleeding are hemoptysis, shortness of breath, and chest tightness.

Spleen. Teenagers are more susceptible to injuries to this organ. Bleeding under the capsule often occurs initially. Only a few days later, due to overstretching, the capsule ruptures, pouring the accumulated fluid into the cavity.

Injuries to the pancreas are a rare phenomenon, as is bleeding itself; the main causes leading to vascular damage are cysts and malignant tumors.

The kidneys are usually injured by a fairly strong blow or compression, as well as by rupture of cysts. Kidney bleeding is accompanied by a characteristic color of urine () and severe pain; it can occur both in the lumen of the organ and in the pelvic cavity.

Symptoms

Usual measures (pressure of the vessel, application of a tourniquet) in in this case does not work. The main task is to deliver the patient to the nearest medical facility as soon as possible.

Before the ambulance arrives, the person should be laid down and cold applied to the suspected site of bleeding. To do this, you can use a heating pad with ice, thermal packs, or a regular bottle of cold water. With a rapid decrease in blood pressure, the leg end is raised 30-40 centimeters above the level of the heart.

Constant monitoring of breathing and heart rate is important; if necessary, resuscitation measures. It is contraindicated to give the victim any medications, including painkillers, food or drink; if you are very thirsty, you are allowed to rinse your mouth with water.

When going to the hospital

In a hospital setting, diagnosis consists of taking an anamnesis and an objective examination of the victim:

• an important point is the presence of blunt trauma or penetrating wound of the chest, abdominal, pelvic cavities;
• probable diseases infectious nature or neoplasms;
• palpation and percussion examination;
• changes in standard parameters - blood pressure, heart rate, body temperature.
• clinical examination reveals signs of acute blood loss.

If damage to the abdominal or pelvic cavity organs is suspected, ultrasound examination provides significant assistance. If necessary, endoscopy is performed.

Medical care in a hospital setting

Definitive treatment, control of bleeding and restoration of lost blood volume, occurs in a hospital setting. Stopping parenchymal bleeding is not an easy task. Hemostatic drugs, such as vikasol and aminocaproic acid, do not have the desired effect. Usually you have to resort to surgical method intervention, but even then the delicate parenchyma tissue often breaks through and bleeds.

As auxiliary methods use diathermocoagulation, application of hemostatic sponges, transfusion of whole donated blood, plasma and platelet mass. If suturing of an organ is not possible, it is resected or removed. Subsequently, the main task is to prevent the development of shock from acute blood loss and restore the required circulating blood volume.

It is important to remember that parenchymal bleeding during injury cannot stop on its own, and every lost hour and day worsens the victim’s condition and increases the risk of complications. Mixed bleeding is especially dangerous, which can lead to death if medical care is not provided in a timely manner.

Belly in human body- the most unprotected area; damage in this area occurs frequently, especially in childhood.

Most of them are not dangerous and do not require medical attention. But some injuries lead to bleeding. Parenchymal bleeding is one of the common reasons for hospitalization. If it is not detected and stopped in a timely manner, it will lead to complications and even death.

Causes

• The main reasons for the development of internal bleeding:
• Injury to blood vessels and organs. Viral diseases
• that violate the integrity of tissues, for example, tuberculosis. Malignant tumors
• at the last stage of progression, they cause bleeding of parenchymal organs during the disintegration of the neoplasm. Benign tumors

subject to their rupture.

In addition to these factors, each individual organ has its own most common causes:

How it manifests itself Despite the high risk to human health, bleeding is not always detected immediately. It often happens that blood loss does not affect the general state

• sick. Signs of parenchymal bleeding at an early stage of progression:
• Weakness.
• Drowsiness..
• Frequent dizziness
• Intense thirst.
• Darkening in the eyes.
• Sweating.

Fainting. arterial pressure:

• With minor blood loss, a slight decrease in blood pressure and increased heart rate are observed. In rare cases, it develops without any symptoms, which creates great danger for the patient, since internal bleeding will not stop on its own.
• Moderate hemorrhage is characterized by an increase in pulse rate to 110 beats per minute and a decrease in systolic pressure below 85 mmHg. Art. In addition, people experience dryness in oral cavity, general weakness, apathy, adynamia, confusion, pale skin, formation of cold sticky sweat.
• In cases of severe blood loss, systolic pressure drops below 80 mmHg. Art., and the pulse rate exceeds 115 beats/min. The victim also appears pathological drowsiness, tremor of the limbs, marbling of the skin, rapid breathing, debilitating thirst, cyanosis and acrocyanosis.
• Massive parenchymal hemorrhage is characterized by a drop in blood pressure to 60 mm Hg. Art. and increased heart rate up to 160 beats/min. The person begins to breathe heavily, his skin turns pale, in rare cases with a grayish tint. Facial features become sharper, eyes become sunken.
• Fatal blood loss is accompanied by the appearance comatose state. In such a case, the pressure drops below 60 mmHg. Art. or not detected, the pulse decreases to 10 beats/min, cramps in the limbs, agonal breathing, dilated pupils, and dry skin appear. Basically, this condition is irreversible - after some time the patient begins to experience agony, after which he dies.

How to stop bleeding

There are several ways to stop bleeding from parenchymal organs:

• Using a special hemostatic sponge.
• By suturing the omentum or removing the damaged part of the organ.
• Electrical coagulation.
• The use of hemostatic drugs (Vikasol, Etamzilat).

First aid

If a person has symptoms that indicate parenchymal bleeding, then he or she must be taken to the hospital immediately. Standard Methods stopping blood, which may include applying a bandage or tourniquet, is useless in this case. Only a surgeon can help a person, since there are no ways to stop parenchymal bleeding at home. But at the same time, there are several recommendations on what to do when a person develops internal bleeding. First aid is provided in the following order:

1. First you need to call an ambulance and describe the person’s condition as accurately as possible.
2. It is necessary to place the patient on a horizontal surface, such as the ground, with his legs elevated.
3. Ice should be applied to the suspected bleeding site.

Surgery

Surgery is the main way to stop blood from internal bleeding. After examining the patient (x-ray, ultrasound of the abdominal cavity), an urgent operation is performed. If questionable test results appear, the surgeon can begin laparoscopic diagnosis. Methods to stop hemorrhage:

• Suturing the omentum.
• Use of hemostatic sponges.
• Application of complex sutures on damaged tissue.
• Embolization of the feeding vessel.
• Removal of the affected part of the organ.
• Electrocoagulation of blood vessels.

At the same time with surgery the patient is given a transfusion of donor blood and administration saline solutions. The main task of the surgeon is to prevent the progression of multiple organ failure and disseminated intravascular coagulation syndrome, in which blood clotting is impaired.

Why is it dangerous?

When blood enters the cavities of internal organs, their function is disrupted. If the blood vessels are compressed, tissue death begins. Blood, which for a long time located in organ cavities, it is a favorable environment for the proliferation of bacteria and the development of microorganisms.
If the victim is not promptly provided medical care and cannot restore blood loss, there is high risk lethal outcome. The body is drained of blood, causing the functioning of the heart and brain to deteriorate.