Bruise vs hematoma

[Birdy2]

I know that a hematoma is a collection of old blood that can get infected, but how do you tell if it's actually that and not just a bruise? One of the nurses I work with said she was worried a patient might be bleeding because of a large bruise and that she wondered if it might be a hematoma. Well, I thought hematomas were old blood, not a sign of active bleeding. The patient supposedly had an abscess after having hysterectomy, but was severely bruised all the way around her body and in a lot of pain. Also her wbcs were pretty elevated. Anyways, I'm just wondering if there are any ways of telling if it's a hematoma or just bruising, other than a ct.

[Rose_Queen, BSN, MSN, RN]

From MedicineNet

By definition, a hematoma is a collection of blood outside of a blood vessel. It occurs because the wall of a blood vessel wall, artery, vein or capillary, has been damaged and blood has leaked into tissues where it does not belong. The hematoma may be tiny, with just a dot of blood or it can be large and cause significant swelling.

Hematomas aren't necessarily "old" blood- I've seen some impressive hematomas that grew as we watched it and were rushing the patient into the OR for vessel repair, sometimes with someone riding on the bed and holding pressure.

From the same site on bruise vs. hematoma

The medical term ecchymosis is what most people would recognize as a bruise, or blood that has leaked out of an injured blood vessel beneath the skin.. Another word for this injury is a contusion. An ecchymosis tends to be flat while a hematoma has more of a three dimensional character to it. As well, hematomas may occur in any organ and not just under the skin.

The link above is only page 2 out of 11 provided by the site on hematomas. You might find some more information there that you're looking for.

[RainMom]

I tend to think of a hematoma as more of a pocket or pooling of blood, deeper within the tissues than an avg bruise.

[Dogen]

Just to nerd it up a bit, the Latin/Greek etymology may help.

Hematoma = blood tumor, or blood growth (see "more of a three dimensional character to it")

Ecchymosis = escape of blood

Fun fact, ecchmyosis has the same root word - the Greek khyma or chymos - as parenchyma. Enkhyma means to pour through, or to pour juice (life juice). They recognized that blood was necessary for life, thought that it carried the "vital force" of life, and so parenchyma is the part of the organ near (para) where the blood is circulating. Ecchymosis is an out (ex) pouring of life juice.