Causes of abdominal bleeding

In our lives, sometimes a disease is very common, such as abdominal bleeding, and there can be many reasons for abdominal bleeding. If gynecological diseases are excluded, we should consider bleeding from abdominal organs, such as the intestines, liver, spleen, etc. Therefore, we must pay great attention to abdominal bleeding to prevent more serious symptoms. Let us now understand the causes of abdominal bleeding!

1. Symptoms of abdominal bleeding

Pathological damage to various organs in the abdominal cavity and rupture of blood vessels can lead to abdominal bleeding. Such symptoms are mostly related to accidental injuries. Check for organ abnormalities or thrombotic problems.

2. Causes of intraperitoneal hemorrhage

Diseases of various organs in the abdominal cavity that damage blood vessels can lead to abdominal bleeding, resulting in serious consequences, such as:

1. In severe acute appendicitis, the mesentery is thickened due to inflammatory edema. When ligating the mesentery blood vessels, it is easy to cut the fragile edematous tissue, resulting in loose ligation of the blood vessels. Or the mesentery is crushed during clamping, and the blood vessels are not tied tightly during ligation.

2. The vascular clamp used to clamp the mesentery becomes loose, causing the blood vessel to retract. When clamping again, the blood vessel is not clamped in place and tied securely.

3. When ligating the mesentery, the surgeon should gradually tighten the ligature under the vascular clamp, and the assistant should also gradually loosen the vascular clamp; if the assistant releases the clamp too quickly, the blood vessel will shrink and not be tied tightly. The broken end of the blood vessel will stop bleeding temporarily due to the squeezing of the vascular clamp, and the lumen will gradually open and bleed after the operation. .

4. During appendectomy, the branches of the appendix artery are not ligated, and the patient may not bleed due to low blood pressure. However, bleeding may occur again after the operation when the blood pressure rises.

5. The ligature is not secure, causing the ligature to loosen and bleed.

6. Bleeding may occur due to inflammatory corrosion or the abdominal drainage tube is placed for too long or is too hard, compressing nearby tissues and blood vessels. The incidence of this type of bleeding is extremely low and the amount of bleeding is also small.

3. Examination of intraperitoneal bleeding

Sudden fainting is a sign of hemorrhagic shock. Sometimes it may spray or overflow from the mouth, nose and other parts. The situation is critical and you should go to the hospital for medical treatment as soon as possible. The difference between upper and lower gastrointestinal bleeding is that it is located proximal or distal to the Treitz ligament. Check the abdominal B-ultrasound to see the specific cause of bleeding, whether there is abnormal shock, whether there is a medical history, pay attention to timely rescue, and check whether there are any problems with blood pressure, etc.

4. Identification of intraperitoneal hemorrhage

Symptoms of intra-abdominal hemorrhage include hemorrhagic shock, severe abdominal pain, and the ability to draw out non-coagulated blood through abdominal puncture, which need to be differentiated from the following symptoms.

1. Gastrointestinal bleeding: Many lesions of the digestive tract can cause bleeding, but most of them can be explained by a few disease diagnoses. Upper and lower gastrointestinal bleeding are differentiated based on whether it is proximal or distal to the ligament of Treitz.

2. Ectopic pregnancy: When the fertilized egg implants outside the uterus, it is called an ectopic pregnancy, commonly known as ectopic pregnancy. Ectopic pregnancy can occur in the fallopian tube, ovary, abdominal cavity, broad ligament, etc. Among them, fallopian tube pregnancy is the most common, accounting for more than 90% to 95% of the incidence.

3. Corpus luteum rupture: Corpus luteum rupture is one of the common gynecological acute abdominal diseases, which is more common in young women aged 14 to 30 years old. Therefore, some people call it the "youth killer."

4. Peritoneal implantation: When cancer cells invade beyond the serosa, they can fall off onto the surface of other organs in the abdominal cavity, causing peritoneal implantation and dissemination. Abdominal implantation and metastasis is a complex biological process. The common sites of occurrence include the greater omentum, mesentery, vesicorectal fossa, rectouterine fossa, etc., and it is more common near the pelvic pouch of Douglas (rectouterine pouch). It can be found as a nodule during vaginal palpation, or it can be widely implanted in the abdominal cavity, forming carcinomatous peritonitis.

5. Hemoperitoneum: When abdominal organs rupture due to intrinsic disease or external injury, blood accumulated during abdominal puncture can confirm hemoperitoneum. The liver is the largest solid organ in the abdominal cavity and is responsible for important physiological functions of the human body. Liver cells have poor tolerance to hypoxia, so the hepatic artery and portal vein provide abundant blood supply, and large and small bile ducts and blood vessels accompany them to transport bile. It is located deep in the right upper abdomen and is protected by the lower chest wall and diaphragm. However, due to its large size and brittle texture, the liver can be easily damaged if subjected to violence, resulting in intra-abdominal bleeding or bile leakage.

6. Sudden fainting is a sign of hemorrhagic shock. Sometimes it may spray or overflow from the mouth, nose and other parts. The situation is critical and you should go to the hospital for medical treatment as soon as possible.

5. Treatment of intraperitoneal hemorrhage

Intraperitoneal hemorrhage is usually caused by rupture of solid organs, the most common of which is spleen rupture, followed by liver rupture. Bleeding can cause hemorrhagic peritonitis, with mild symptoms. The patient is in general poor condition, has low blood pressure, and may have symptoms of shock. Pay attention to check whether there is rupture of hollow organs; abdominal X-ray is necessary. If there is free abdominal air or obvious peritonitis, suspect a ruptured hollow organ. Diagnostic abdominal puncture is possible, and the nature of the fluid discharged can determine organ damage. After treating the shock, the patient is quickly pushed into the operating room. A ruptured spleen requires removal, a ruptured liver depends on the specific circumstances, and other combined injuries also depend on the specific circumstances. What needs attention in intra-abdominal bleeding is retroperitoneal bleeding, which is usually caused by pelvic fracture, has an insidious onset and is extremely harmful. If a patient with pelvic fracture is found to have low blood pressure, shock and other symptoms, retroperitoneal hematoma should be highly suspected!