Haematoma

When an implant is surgically inserted into the human body, the internal environment is greatly disturbed. Haematomas are likely to collect around the implant, resulting in a lowered pH. Laing observed pH values as low as 4-0 in healing wounds. The low pH usually persists until the haematomas are reabsorbed after several weeks ... 

Therapeutic levels immediately after infusion, irrespective of which product is used, require factor VIII levels between 5 and 20 % for hae-marthrosis and muscle bleeds. However, haematoma in dangerous areas, such as extensive dental extractions, should have levels between 20 and 40 %. For major surgery and serious accidents these need to be between 100 and 150 % levels should not drop below 50 % at any point in the day and should continue until wound healing is complete in major surgery this may be 7 or 10 days. 

Bruises are signified by swellings, haematomas and pain. The bruised should be given first before-doctor aid, such as applying a cold wash and pressure bandage to the bruised area (to reduce inner haemorrage). 

Alemany Ripoll M, Stenborg A, Sonninen P et al (2004) Detection and appearance of intraparenchymal haematomas of the brain at 1.5 T with spin-echo, FLAIR and GE sequences poor relationship to the age of the haematoma. Neuroradiology 46 435-443... 

Transient hippocampal hypermetabolism associated with glutamate release after acute subdural haematoma in the rat a potentially neurotoxic mechanism J. Cereb. Blood Flow Metab. 11, S109 (Abstr). 

McIntyre IM, Hamm CE, Sherrad JL, Gary RD, Riley AC, Lucas JR. The analysis of an intracerebral haematoma for drugs of abuse. J Forensic Sci 2003 48 680-2. 

Rabinstein AA, Atkinson JL, Wijdicks EFM (2002). Emergency craniotomy in patients worsening due to expanded cerebral haematoma to what purpose Neurology 58 1367-1372... 

Duration of therapy is determined by speed of recovery of the affected joint or resolution of a haematoma. After surgery at least 10-14 days of replacement therapy is required to ensure adequate wound healing and scar formation. 

Deficiency of ascorbic acid leads to scurm/, which is characterised by petechial haemorrhages, haematomas, bleeding gums (if teeth are present) and anaemia. It has a memorable place in the history of therapeutic measurement. 

R. Virchow described Hamatoidin and the extra-hepatic synthesis of bile pigments from haematoidin in old haematomas (s. Galenos blood turns to bile ). 

Impotence, amenorrhoea, nosebleeds, bleeding gums, tendency to haematoma, night blindness = which can also lead to a wrong diagnostic conclusion. 

After removing the needle, do not bend the arm but elevate it -tiiis will empty the vein and avoid bleeding as well as preventing haematoma. 

The following lesions may be hypoechoic (7.) metas-tases, (2.) liver cell carcinoma, (3.) adenomas, (4.) focal nodular hyperplasia, (5.) abscesses, (6.) haematomas, (7.) early liver infarction, (S.) foci showing reduced fatty infiltration, (9.) lymphomas, and (10.) lipomas. In individual cases, differentiation between a benign and a malignant structural defect may cause considerable difficulties. (59) (s. fig. 9.4)... 

Macronodular tuberculosis (51), granulomatosis of the liver (60) and particularly liver metastases may likewise appear as focal liver diseases with differing echogenicity. Flaematomas are initially hyperechoic, but turn hypoechoic when they liquefy within a few days, and even become echofree at a later stage. Older haematomas usually revert to being hyperechoic. (48, 85)... 

Pain in the right shoulder and possibly cervicalgia on the right side due to irritation of the phrenic nerve. (3.) Respiratory pain as a result of a subcapsular haematoma. 

There are only isolated reports of late bleeding (4 to 13 day). (78, 127, 177) This may be attributed to late fibrinolysis of the thrombus in the area of the biopsy canal. These reports do not, however, exclude more obvious causes, e. g. abdominal press, traumatization, rupture of a subcapsular haematoma, influence on blood... 

Each laparoscopy should aim at a visual assessment of the spleen in terms of (7.) size, (2.) colour, (i.) shape, and (4.) identifiable spleen diseases. Special mention should be made of capsular fibrosis, hyalinosis ( sugar-coated spleen ), tumours (e. g. Hodgkin s disease, retothelial sarcoma), tuberculosis, splenic cysts, splenic infarction (s. fig. 35.10) and splenic haematoma. Given appropriate positioning, the spleen is visible in 80% of cases. In the case of myeloproliferative diseases, a biopsy of the spleen (e. g. by means of the Menghini technique) can provide a definitive diagnosis, (s. pp 135,253) (s. figs. 11.1 14.7) (see chapter 11)... 

Haematoma jaundice with retrogression of large haematomas due to the fact that 1 litre of blood produces about 5 g bilirubin, which is 20 times the normal daily bilirubin production. 

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