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Bruising

Bruise
Pferdekuss.jpg
Bruise on upper leg caused by a blunt object
Classification and external resources
Specialty Emergency medicine
ICD-10 S00-S90, T14.0
ICD-9-CM 920-924
DiseasesDB 31998
MedlinePlus 007213
eMedicine article/88153
MeSH D003288
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A contusion, commonly known as a bruise, is a type of hematoma of tissue in which capillaries and sometimes venules are damaged by trauma, allowing blood to seep, hemorrhage, or extravasate into the surrounding interstitial tissues. Bruises, which do not blanch under pressure, can involve capillaries at the level of skin, subcutaneous tissue, muscle, or bone. Bruises are not to be confused with other similar-looking lesions primarily distinguished by their diameter or causation. These lesions include petechia (< 3 mm result from numerous and diverse etiologies such as adverse reactions from medications such as warfarin, straining, asphyxiation, platelet disorders and diseases such as cytomegalovirus),purpura (3 mm to 1 cm, classified as palpable purpura or non-palpable purpura and indicates various pathologic conditions such as thrombocytopenia), and ecchymosis (>1 cm caused blood dissecting through tissue planes and settled in an area remote from the site of trauma or pathology such as periorbital ecchymosis, i.e.,"raccoon eyes" , arising from a basilar skull fracture or from a neuroblastoma).

As a type of hematoma, a bruise is always caused by internal bleeding into the interstitial tissues which does not break through the skin, usually initiated by blunt trauma, which causes damage through physical compression and deceleration forces. Trauma sufficient to cause bruising can occur from a wide variety of situations including accidents, falls, and surgeries. Disease states such as insufficient or malfunctioning platelets, other coagulation deficiencies, or vascular disorders, such as venous blockage associated with severe allergies can lead to the formation of purpura which is not to be confused with trauma-related bruising/contusion. If the trauma is sufficient to break the skin and allow blood to escape the interstitial tissues, the injury is not a bruise but instead a different variety of hemorrhage called bleeding. However, such injuries may be accompanied by bruising elsewhere.


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