15:51 PM

More Than a Bruise

Hematomas might seem similar to a bruise but can require surgery

A slip and fall injury in your home or driveway may result in a hematoma. Though similar to a bruise, a hematoma is a pool of clotted or partially clotted blood that forms when blood vessels leak or burst. A hematoma can occur deep in the abdominal wall, within internal organs, or in large muscle groups like the thigh. It creates a painful mass and causes surrounding tissues to deteriorate.

When this happens, see your primary care provider for advice, says surgeon Jonathan Perry, MD, with LVPG Surgery–Health & Wellness Center, Hazle Township. Perry specializes in limb and abdominal hematoma treatment.

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Jonathan Perry, MD

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Who is at risk for hematomas?

“Hematomas often occur in older people with fragile skin and tissues,” Perry says. Also, people who take blood thinners, such as aspirin or warfarin (Coumadin®), are at increased risk. Hematomas can result if you fall or sustain any injury that causes blood vessels to break.

How is a hematoma treated?

Most hematomas resolve with conservative methods, including RICE – rest, ice, compression and elevation. Perry approaches surgical treatment with caution, performing blood tests at specific intervals to determine if internal bleeding is ongoing. “We only intervene when the body’s natural repair system isn’t working,” he says.

What is involved in surgical hematoma care?

Surgical treatment starts by locating the hematoma with a computed tomography (CT) scan. “Once we know exactly where it is, we make an incision in the skin, place a few sutures in tissues around the hematoma to provide internal compression and pack the area with surgical gauze,” he says. Gauze may be left in place for a few days until bleeding stops and the body starts to reabsorb excess blood. At that point, Perry performs a second surgery to remove the gauze and close the wound. 

When should you get help?

“If you have pain, swelling or skin discoloration that isn’t getting better, it’s important to get checked for a possible hematoma,” he says. “Elderly people and those with balance problems should do everything they can to reduce their risk for falls, including strengthtraining exercises or rehabilitation. And finally, it’s important to take blood-thinning medications exactly as directed and to review the need for these medications with your doctor on a regular basis.”