Equis ISSN 2398-2977

Hematoma

Contributor(s): Vetstream Ltd

Introduction

  • Cause: trauma - accidental, foaling trauma, physiologic (follicular hemorrhage) or surgical   →   subserosal, subcutaneous or intramuscular hemorrhage   →   accumulation of blood, serum or tissue exudate.
  • Signs: swelling; firm   →   fluctuant; localized pain and heat. Delayed surgical wound healing.
  • Diagnosis: physical examination, needle aspiration, ultrasonography, rectal palpation, response to therapy.
  • Treatment: none   →   cold treatments, local and systemic non-steroidal anti-inflammatory drugs, drainage, pressure bandaging, physiotherapy.
  • Prognosis: good; incisional wounds may have delayed healing.
  • See also:
  • Wound: contusions .
  • Ethmoid hematoma   Ethmoid: hematoma  .
  • Ovary: hematoma .
  • Penis: trauma   Penis: trauma  .
  • Scrotum: trauma   Scrotum: trauma  .
  • Foot: sole bruising   Foot: sole bruising  .

Pathogenesis

Etiology

  • Ovulation   →   excessive follicular hemorrhage.

Predisposing factors

General
  • Horses loose in paddock.

Pathophysiology

General
  • Trauma   →   rupture of micro- and macrovasculature   →   local hemorrhage and inflammation   →   accumulation of fluids   →   localized swelling, pain and heat.
  • Continued hemorrhage   →   swelling enlarges gradually   →   inflammatory response and organization of fluid   →   cessation of hemorrhage   →   swelling firms   →   gradual reduction in size and associated clinical signs.
  • Open wound associated with swelling   →   possible infection   →   abscessation.

  • Surgery
  • Surgical wounds are more likely to develop hematoma or seroma where the following factors are present:
  • Hemorrhage.
  • Tissue trauma.
  • Creation of dead space.
  • Excessive movement at wound site.
  • Hemoglobin   →   inhibits local tissue defences.
  • Iron   →   substrate for bacterial replication and virulence.

  • Ovarian hematoma
  • Ovulation   →   hemorrhage into follicular cavity > normal   →   enlarged ovary:
  • Uneventful resolution.
  • Occasionally destruction of germinal tissue   →   permanent unilateral loss of ovarian function.

Timecourse

  • Acute trauma   →   swelling develops within hours.
  • Continued hemorrhage   →   swelling enlarges over several days.
  • Resolution usually:
  • Hematomas <10 cm diameter, 7-14 days.
  • Hematomas >10 cm diameter, 14-28 days.

Some limb hematomas never fully resolve but persist as a fluid filled swelling, eg false thoroughpin

Diagnosis

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Treatment

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Prevention

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Outcomes

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Sedrish Set al(1998)Theriogenology question of the month. Conservative medical management using cold-water hydrotherapy.JAVMA212(2), 197-198 PubMed.
  • Ragle C Aet al(1998)Injury to abdominal wall vessels during laparoscopy in three horses.JAVMA212(1), 87-89 PubMed.
  • Sedrish Set al(1997)Theriogenology question of the month. Excessive hemorrhaging from ovarian hematomas on both ovaries.JAVMA210(2) 179-180 PubMed.
  • Van Hoogmoed Let al(1996)Acute small intestinal injury associated with hematomas in the mesentery of four horses.JAVMA209(8) 1453-1456 PubMed.
  • Hyland Jet al(1995)The use of ultrasonography in the diagnosis and treatment of a haematoma in the corpus cavernosum penis of a stallion.Aust Vet J72(12), 468-469 PubMed.
  • Maxson A Det al(1993)Use of a bovine hemoglobin preparation in the treatment of cyclic ovarian hemorrhage in a miniature horse.JAVMA203(9) 1308-1311 PubMed.
  • Dyke T Met al(1988)Ruptured splenic haematoma in a mare.Equine Vet J192(3), 379-380 PubMed.
  • Kobluk C Net al(1988)Intramural hematoma in the jejunum of a mare.JAVMA192(3), 379-380 PubMed.
  • Memon M Aet al(1987)Preputial hematoma in a stallion.JAVMA191(5), 563-364 PubMed.
  • Spier Set al(1986)Splenic hematoma and abscess as a cause of chronic weight loss in a horse.JAVMA189(5) 557-559 PubMed.
  • Pearson Het al(1986)Submucosal haematoma as a cause of obstruction of the small colon in the horse - a review of four cases.Equine Vet J18(4) 340-341 PubMed.
  • Brown C Met al(1981)Gastric hematoma in a horse.Mod Vet Pract62(8), 617-618 PubMed.


ADDED