Blood is a essential liquid tissue in the body which performs function of transporting raw materials and oxygen from the point of assimilation to usage. There is always about 4 to 5 litres of blood in an fully grown adult. The quantity and quality of has a very strong influence on the bodily functions. Derangements of any severity can have overt clinical symptoms and signs.
Poor quality of blood tissue comprises conditions characterized by reduced cell count, reduced cell quality in-terms of reduced cellular contents like low haemoglobin (iron deficiency anaemia), poor nucleic acid maturation (megaloblastic anaemia) etc. These present with defect of poor raw material and oxygen transfer to the tissue. Most of these conditions are chronic, symptoms and signs develop over a long term. Here the blood quantity remains fairly normal as there is no acute loss of there is good amount of supporting fluid called plasma comprising of mostly water. In such cases one can Ask a doctor for supplementations which can correct the defects in blood.
Reduced quantity of blood which is commonly encountered in cases of acute blood loss like in trauma or intestinal perforation also presents with signs of symptoms developed over short time.
Symptoms seen in acute blood loss due to internal bleeding depends on the part from which the bleeding occurs
- Headache, Stiffness in the neck, confusion, Light headedness , symptoms of stroke like -vision loss, weakness , slurred speech, vomiting. These symptoms are most of times of specific for intra cranial bleed. Sometimes these bleeds
- Pain in the abdomen in cases of intestinal perforation which can result in peritonitis
- Pain in the trauma affected parts in cases of internal bleed due to trauma like road traffic accidents or assault involving blunt of stab injuries. The pain in these cases could be due to peritonitis due to spilled contents or blood into peritoneal cavity.
- In cases of luminal bleed in gastrointestinal system, patient may not experience pain in most of cases but present with frank blood in stools or altered blood in stools as black tarry stools called malena.
- Feeling cold and clamy in extremities, this occurs as a result of blood loss and reduced blood pressure as an effect
- Palpitation , feeling of one’s own heart beat. This occurs due to increased heart rate seen in cases of internal bleed.
- There could be internal bleeding in joints which can result in stiffness and pain in the joints associated with swelling.
- Gross hematuria, blood stained urine is a symptom noticed when there is bleed in the urinary system secondary to infection or stones.
- Cancers can sometimes invade the blood vessels and lead to internal bleeding. These may most of times be silent without any pain but present with signs of blood loss.
- Shortness of breath when there is bleed in lungs or pleural cavity usually seen in trauma.
Sings of internal bleeding are few medical parameters determined or observations made by the doctor to elicit presence or severity of internal bleed
- Increased heart rate – when there is low blood volume , reflex increase in heart rate occurs to make sure that the organs get enough blood.
- Low blood pressure, though there is increased heart rate low blood volume does not make it to fill up the vascular space and present with drop in blood pressure.
- Cold extremities occurs due to poor perfusion due to low blood volume.
- In case of intracranial bleed, there might be papillary constriction on the side of bleed, papilloedema seen via ophthalmoscope, a triad of increased blood pressure, increased pulse rate, irregular breathing is sometimes seen in case of intracranial bleed, this is called Cushing triad or reflex.
The signs and symptoms of internal bleed usually depend on the site of involvement. A doctor after collecting a detailed history and performing clinical examination may be able to pin point the site of bleed and severity of the same. Hence signs and symptoms hold a great importance in management of a internal bleed.