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What is abdominal hematoma?

Abdominal hematoma is a collection of blood inside the abdomen (intra-abdominally) or in the abdominal wall.

Causes of an abdominal hematoma

Abdominal hematomas are uncommon and difficult to diagnose as they can be caused by many things and associated with many other complications, but always a result of bleeding in the abdominal cavity or abdominal wall. The bleeding may result from disruption of a splenic or hepatic mass (liver or spleen), muscular tear and rupture of epigastric vessels. Doctors typically need to perform physical, laboratory and ultrasound tests to confirm the size, location and possible causes of the hematoma. Precipitating and risk factors include:

• Blunt or penetrating abdominal trauma
• Systemic anticoagulation defects: anticoagulation associated with leukemia, myeloproliferative disorders, hemophilia, and blood dyscrasiascan can be a predisposing factor or direct cause of an abdominal hematoma
• Coughing and sneezing: an abdominal hematoma can occur after episodes of severe coughing and sneezing
• Previous abdominal surgery: surgical scars may redirect the shearing forces on muscle contraction, placing more stress on the epigastric vessels and causing them to rupture
• Recent abdominal surgery: excessive retraction or poor aftercare can cause a postoperative abdominal hematoma.

Signs and symptoms of an abdominal hematoma

Depending on the size, location and whether the onset of abdominal hematoma is acute or chronic, one or more of the symptoms below may occur:

• Sharp and severe pain from the abdominal cavity, abdominal organs or the nerves, muscles, fascia or skin associated with the abdomen. Possitive carnett’s sign may indicate that the hematoma is located in the abdominal wall.
• Abdominal rigidity and organomegaly (abnormal enlargement of organs)
• Peritoneal irritation, typically if the location of the hematoma is near the peritoneum
• Gastrointestinal symptoms: anorexia, nausea, vomiting, diarrhea, constipation, tenesmus, and bladder irritability
• Fever and chills, symptoms of hypovolemic shock with weakness, confusion, pallor, and diaphoresis may occur in patients with a large abdominal hematoma due to solid organ injury or rupture of an abdominal aortic aneurysm
• Discoloration in the abdominal skin

Treatment of an abdominal hematoma

As stated, abdominal hematoma is a serious and complex pathology that needs urgent specialist care. Consult your doctor when you experience one of the above symptoms.