Internal Bleeding

Internal bleeding occurs inside the body and may not be visible. It can develop after trauma, from blood vessel rupture, or from anticoagulant medications, and can become life-threatening quickly.

Quick Facts

  • ICD-10: Various
  • Risk: Severe blood loss without external signs

Warning Signs — Call 911

Suspect internal bleeding with:
  • Severe abdominal, chest, or back pain after trauma
  • Pale, cold, or clammy skin
  • Rapid heart rate and weak pulse
  • Dizziness, fainting, or confusion
  • Visible bruising or swelling
  • Shortness of breath
  • Black stools or vomiting blood

Common Causes

  • Trauma — motor vehicle crashes, falls, blunt or penetrating injury
  • Ruptured aneurysm
  • Gastrointestinal bleeding
  • Ectopic pregnancy
  • Anticoagulant medications
  • Bleeding disorders
  • Postoperative complications

Diagnosis

  • Bedside ultrasound (FAST exam in trauma)
  • CT scan
  • Blood tests (hemoglobin, coagulation)
  • Diagnostic peritoneal lavage (rarely used now)

Treatment

  • Resuscitation with IV fluids and blood products
  • Reverse anticoagulants when appropriate
  • Surgical or interventional control of bleeding
  • Treat underlying cause
Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about a medical condition. If you are experiencing a medical emergency, call your local emergency number immediately.

References

  • American College of Surgeons. Trauma Resources.