Bovis ISSN 2398-2993

Hematoma

Synonym(s): Bruise

Contributor(s): Catherine Fraser , Ben Dustan

Introduction

  • Cause: trauma. Trauma may be accidental, calving trauma, physiologic ie follicular hemorrhage or surgical ie subserosal, subcutaneous or intramuscular hemorrhage → accumulation of blood, serum or tissue exudate.
  • Signs: swelling may be firm to fluctuant with localized pain and heat. Delayed surgical wound healing.
  • Diagnosis: physical examination, needle aspiration, ultrasonography, rectal palpation, response to therapy.
  • Treatment: none or cold treatments, local and systemic non-steroidal anti-inflammatory drugs, drainage, pressure bandaging, physiotherapy.
  • Prognosis: good, although incisional wounds may have delayed healing.

Pathogenesis

Etiology

  • Trauma.
  • Kick.
  • Collision.
  • Fall.
  • Fracture.
  • Mating.
  • Calving.
  • Ovulation → excessive follicular hemorrhage.
  • Poor platelet function in some breed lines of black Japanese cattle.

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.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Braun U, Trösch L & Sydler T (2014) Ruptured urinary bladder attributable to urethral compression by a haematoma after vertebral fracture in a bull. Acta Vet Scand 26 (56), 1 PubMed.
  • Akuzawa M, Morizono M, Yasuda N, Okamoto K & Matumoto M (1991) Persistent hematomas in Japanese black cattle with impaired platelet aggregation function and large granule eosinophils. J Vet Med Sci 53 (1), 107-12 PubMed.


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