bruise

More about Bruises: Causes and symptoms Diagnosis Treatment Alternative treatment Prognosis Prevention Resources

Definition

Bruises, or ecchymoses, are a discoloration and tenderness of the skin or mucous membranes due to the leakage of blood from an injured blood vessel into the tissues. Pupura refers to bruising as the result of a disease condition. A very small bruise is called a petechia. These often appear as many tiny red dots clustered together, and could indicate a serious problem.

Description

Bruises change colors over time in a predictable pattern, so that it is possible to estimate when an injury occurred by the color of the bruise. Initially, a bruise will be reddish, the color of the blood under the skin. After one to two days, the red blood cells begin to break down, and the bruise will darken to a blue or purplish color. This fades to green at about day six. Around the eighth or ninth day, the skin over the bruised area will have a brown or yellowish appearance, and it will gradually diminish back to its normal color.

Long periods of standing will cause the blood that collects in a bruise to seep through the tissues. Bruises

are actually made of little pools of blood, so the blood in one place may flow downhill after awhile and appear in another. For instance, bruising in the back of the abdomen may eventually appear in the groin; bruising in the thigh or the knee will work its way down to the ankle.

— Patience Paradox

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v., bruised, bruis·ing, bruis·es.

v.tr.

1. 1. To injure the underlying soft tissue or bone of (part of the body) without breaking the skin, as by a blow.
   2. To damage (plant tissue), as by abrasion or pressure: bruised the fruit by careless packing.
2. To dent or mar.
3. To pound (berries, for example) into fragments; crush.
4. To hurt, especially psychologically.

v.intr.

To experience or undergo bruising: Peaches bruise easily.

n.

1. An injury to underlying tissues or bone in which the skin is not broken, often characterized by ruptured blood vessels and discolorations.
2. A similar injury to plant tissue, often resulting in discoloration or spoilage.
3. An injury, especially to one's feelings.

[Middle English bruisen, from Old English brȳsan, to crush, and from Old North French bruisier (of Germanic origin).]

Visible bruising is well known to result from a blunt injury to the body surface. It may also follow deeper injuries — sprains or fractures — but this takes longer to show itself. A bruise is due to rupture of blood vessels and escape of blood into the interstices among the cells and connective tissue beneath the outermost layer of skin. The red blood cells break down, and their pigment, haemoglobin, undergoes chemical changes which account for the sequence of colours in the bruise. The debris is eventually removed by macrophages. A bruise can likewise occur internally on or in any organ or tissue subjected to a blow, squeeze or stretch: contusion is an alternative term.

— Stuart Judge

contusion

A bruise is likely to develop whenever your body collides with another object, so it is a very common injury in any contact sport. A bruise forms from seepage of blood in an internal wound. The blood gradually decomposes, changing colour from red to blue as haemoglobin loses its oxygen, and then to yellow as the haemoglobin is reabsorbed. The accumulation of blood in damaged tissues can be reduced by applying firm pressure for 3-5 minutes immediately after the injury, followed by a cold compress. See also haematoma.

[BROOZ] In cooking, to partially crush an ingredient in order to release its flavor. Bruising a garlic clove with the flat side of a knife crushes without cutting it.

verb

To make a bruise or bruises on: contuse. See help/harm/harmless.

n

In medical terminology, a contusion; an injury made on the flesh by an instrument, without breaking the skin.

Definition

Bruises, or ecchymoses, are a discoloration and tenderness of the skin or mucous membranes due to the leakage of blood from an injured blood vessel into the tissues. Pupura refers to bruising as the result of a disease condition. A very small bruise is called a petechia. These often appear as many tiny red dots clustered together, and could indicate a serious problem.

Description

Bruises change colors over time in a predictable pattern, so that it is possible to estimate when an injury occurred by the color of the bruise. Initially, a bruise will be reddish, the color of the blood under the skin. After one to two days, the red blood cells begin to break down, and the bruise will darken to a blue or purplish color. This fades to green at about day six. Around the eighth or ninth day, the skin over the bruised area will have a brown or yellowish appearance, and it will gradually diminish back to its normal color.

Long periods of standing will cause the blood that collects in a bruise to seep through the tissues. Bruises are actually made of little pools of blood, so the blood in one place may flow downhill after awhile and appear in another. For instance, bruising in the back of the abdomen may eventually appear in the groin; bruising in the thigh or the knee will work its way down to the ankle.

Causes & Symptoms

Healthy people may develop bruises from any injury that doesn't break through the skin. Vigorous exercise may also cause bruises due to bringing about small tears in blood vessels walls. In a condition known as purpura simplex, there is a tendency to bruise easily due to an increased fragility of the blood vessels. Bruises also develop easily in the elderly, because the skin and blood vessels have a tendency to become thinner and more fragile with aging, and there is an increased use of medications that interfere with the blood clotting system. In the condition known as purpura senilis, the elderly develop bruises from minimal contact that may take up to several months to completely heal.

The use of nonsteroidal anti-inflammatories such as ibuprofen (Advil) and naproxen (Aleve) may lead to increased bruising. Aspirin, antidepressants, asthma medications, and cortisone medications also have this effect. The anti-clotting medications also known as blood thinners, especially the drug warfarin (Coumadin), may be the cause of particularly severe bruising.

Sometimes bruises are connected with more serious illnesses. There are a number of diseases that cause excessive bleeding or bleeding from injuries too slight to have consequences in healthy people. An abnormal tendency to bleed may be due to hereditary bleeding disorders, certain prescription medications, diseases of the blood such as leukemia, and diseases that increase the fragility of blood vessels. If there are large areas of bruising or bruises develop very easily, this may herald a problem. Other causes that should be ruled out include liver disease, alcoholism, drug addiction, and acquired immune deficiency syndrome (AIDS). Bruising that occurs around the navel may indicate dangerous internal bleeding; bruising behind the ear, called Battle's sign, may be due to a skull fracture; and raised bruises may point to autoimmune disease.

Diagnosis

Bruising is usually a minor problem, which does not require a medical diagnosis. However, faced with extensive bruising, bruising with no apparent cause, or bruising in certain locations, a physician will pursue an evaluation that will include a number of blood tests. If the area of the bruise becomes hard, an x ray may be required.

Treatment

Several types of topical applications are usually recommend to speed healing and to reduce the pain associated with bruises. Vitamin K cream can be applied directly to the site of injury. Astringent herbs such as witch hazel, Hamamelis virginiana, can be used. This will tighten the tissues and therefore diminish the bruising. The homeopathic remedy, Arnica montana, can be applied as a cream or gel to unbroken skin.

Oral homeopathic remedies may reduce bruising, pain, and swelling as well. Arnica montana, at 30 ml (1 oz), taken one to two times per day is highly recommended. For ledum, 30 ml (1 oz) one to two times per day is also useful.

Allopathic Treatment

A bruise by itself needs no medical treatment. It is often recommended that ice packs be applied on and off during the first 24 hours of injury to reduce the bruising. After that, heat, especially moist heat, is recommended to increase the circulation and the healing of the injured tissues. Rest, elevation of the effected part, and compression with a bandage will also retard the accumulation of blood. Rarely, if a bruise is so large that the body cannot completely absorb it or if the site becomes infected, it may have to be surgically removed.

Expected Results

The blood under the skin which causes the discoloration of bruising should be totally reabsorbed by the body in three weeks or less. At that time, the skin color should completely return to normal.

Sometimes, a bruise may become solid and increase in size instead of dissolving. This may indicate blood trapped in the tissues, which may be need to be drained. This is referred to as a hematoma. Less commonly, the body may develop calcium deposits at the injury site in a process called heterotopic ossification.

Prevention

Vitamin K promotes normal clotting in the blood, and therefore may help reduce the tendency to bruise easily. Green leafy vegetables, alfalfa, broccoli, seaweed, and fish liver oils are dietary sources of vitamin K. Other good foods to eat would be those containing bioflavonoids, such as reddish-blue berries. These can assist in strengthening the connective tissue, which will decrease the spread of blood and bruising. Zinc and vitamin C supplements are also recommended for this.

Resources

Books

Editors of Prevention Magazine Health Books, eds. The Doctors Book of Home Remedies. Prevention Health Books, 2000.

Feinstein, Alice, ed. Prevention's Healing With Vitamins: The Most Effective Vitamin and Mineral Treatments for Everyday Health Problems and Serious Disease. Prevention Health Books, 1998.

Williams, William J. Williams' Hematology. New York: McGraw-Hill, 1995.

[Article by: Paula Ford-Martin; Rebecca J. Frey, PhD]

Definition

Bruises, or ecchymoses, are a discoloration and tenderness of the skin or mucous membranes due to the leakage of blood from an injured blood vessel into the tissues. Purpura refers to bruising as the result of a disease condition. A very small bruise is called a petechia. These often appear as many tiny red dots clustered together and could indicate a serious problem.

Description

Bruises change colors over time in a predictable pattern, so that it is possible to estimate when an injury occurred by the color of the bruise. Initially, a bruise will be reddish, the color of the blood under the skin. After one to two days, the red blood cells begin to break down, and the bruise will darken to a blue or purplish color. This color fades to green at about day six. Around the eighth or ninth day, the skin over the bruised area will have a brown or yellowish appearance, and it will gradually fade back to its normal color.

Long periods of standing cause blood that collects in a bruise to seep through the tissues. Bruises are actually made of little pools of blood, so the blood in one place may flow toward the ground, and the bruise may appear in another location. For instance, bruising in the back of the abdomen may eventually appear in the groin; bruising in the thigh or the knee will work its way down to the ankle.

Demographics

All persons develop bruises at many times during their lives. The condition is entirely natural and normal.

Causes and Symptoms

Healthy people may develop bruises from any injury that does not break through the skin. Vigorous exercise may also cause bruises due to bringing about small tears in blood vessels walls. In a condition known as purpura simplex, there is a tendency to bruise easily due to an increased fragility of the blood vessels. Bruises also develop easily in the elderly, because the skin and blood vessels have a tendency to become thinner and more fragile with aging, and there tends to be an increased use of medications that interfere with the blood clotting system. In the condition known as purpura senilis, the elderly develop bruises from minimal contact that may take up to several months to completely heal.

The use of nonsteroidal anti-inflammatories such as ibuprofen and naproxen sodium may lead to increased bruising. Aspirin, antidepressants, asthma medications, and cortisone medications also have this effect. The anticlotting medications also known as blood thinners, especially the drug warfarin (Coumadin), may be the cause of particularly severe bruising.

Sometimes bruises are linked with more serious illnesses. There are a number of diseases that cause excessive bleeding or bleeding from injuries too slight to have consequences in healthy people. An abnormal tendency to bleed may be due to hereditary bleeding disorders, certain prescription medications, diseases of the blood such as leukemia, and diseases that increase the fragility of blood vessels. If there are large areas of bruising or bruises develop very easily, this may herald a problem. Other causes that should be ruled out include liver disease, alcoholism, drug addiction, and acquired immune deficiency syndrome (AIDS). Bruising that occurs around the navel may indicate dangerous internal bleeding; bruising behind the ear, called Battle's sign, may be due to a skull fracture; and raised bruises may point to autoimmune disease.

When to Call the Doctor

A physician or healthcare professional should be consulted when accidents involve extensive bruising or when bruises do not heal in a timely manner (seven to 10 days). A physician should be called if bruises appear in unusual locations on the body such as on the back or around the eyes or wrists. Such injuries are often the result of abuse.

Diagnosis

Bruising is usually a minor problem that does not require a formal medical diagnosis. However, faced with extensive bruising, bruising with no apparent cause, or bruising in certain locations, a physician will pursue an evaluation that includes a number of blood tests. If the area of the bruise becomes hard, an x ray may be required.

Treatment

A bruise by itself usually requires no medical treatment. It is often recommended that ice packs be applied on and off during the first 24 hours after injury to reduce the bruising. After that, heat, especially moist heat, is recommended to increase the circulation and the healing of the injured tissues. Rest, elevation of the affected part, and compression with a bandage will also retard the accumulation of blood. Rarely, if a bruise is so large that the body cannot completely absorb it or if the site becomes infected, it may have to be surgically removed.

Several types of alternative treatments are often recommended to speed healing and to reduce the pain associated with bruises. Most of these treatments are topical in nature and frequently include vitamin K cream can be applied directly to the site of injury. Astringent herbs such as witch hazel, Hamamelis virginiana, can be used. This treatment will tighten the tissues and therefore diminish the bruising. The homeopathic remedy, Arnica montana, can be applied as a cream or gel to unbroken skin.

Oral homeopathic remedies may reduce bruising, pain, and swelling as well. Arnica montana, at 30 ml (1 oz), taken one to two times per day is highly recommended.

Prognosis

The blood under the skin which causes the discoloration of bruising should be totally reabsorbed by the body in three weeks or less. At that time, the skin color should have completely returned to normal.

Sometimes a bruise may become solid and increase in size instead of dissolving. This may indicate blood trapped in the tissues, which may need to be drained. This condition is referred to as a hematoma. Less commonly, the body may develop calcium deposits at the injury site in a process called heterotopic ossification.

Prevention

Vitamin K promotes normal clotting in the blood and, therefore, may help reduce the tendency to bruise easily. Green leafy vegetables, alfalfa, broccoli, seaweed, and fish liver oils are good dietary sources of vitamin K. Other good foods to eat are those containing bioflavonoids, such as reddish-blue berries. These can assist in strengthening the connective tissue, which decreases the spread of blood and bruising. Zinc and vitamin C supplements are also recommended for this purpose.

Nutritional Concerns

A balanced diet that includes green leafy vegetables and broccoli should provide a sufficient source of vitamin K. Vitamin C and zinc supplements are also helpful.

Parental Concerns

Parents should provide a balanced diet for their children. They should also provide appropriate care for bruises that inevitably occur.

Resources

Books

Gordon, Sharon, and Nanci Varquis. Bruises. New York: Scholastic Library Publishing, 2002.

Royston, Angela. Bumps and Bruises. Orlando, FL: Heinemann Library, 2004.

——. Why Do Bruises Change Color?: And Other Questions about Blood. Orlando, FL: Heinemann Library, 2003.

Periodicals

Baruch, M. B., and R. Beck-Little R. "A 12-year-old boy with multiple bruises and a dislocated knee but no reported injury." Journal of Emergency Nursing 30, no. 3 (2004): 213–5.

Gates, D. "Burgers or bruises? Being assaulted shouldn't be part of a nurse's aide's job." American Journal of Nursing 104, no. 9 (2004): 13–4.

Sibert, J., et al. "Bruising, coagulation disorder, and physical child abuse." Blood Coagulation and Fibrinolysis 15, no. Supplement 1 (2004): S33–9.

Yamagami, T., et al. "Clinical features of snowboarding injuries." Journal of Orthopedic Science 9, no. 3 (2004): 225–9.

Organizations

American Academy of Emergency Medicine. 611 East Wells Street, Milwaukee, WI 53202. Web site: www.aaem.org/.

American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211–2672. Web site: www.aafp.org/.

American Academy of Pediatrics. 141 Northwest Point Boulevard, Elk Grove Village, IL 60007–1098. Web site: www.aap.org/.

American Academy of Physical Medicine and Rehabilitation. One IBM Plaza, Suite 2500, Chicago, IL 60611–3604. Web site: www.aapmr.org/.

American College of Emergency Physicians. PO Box 619911, Dallas, TX 75261–9911. Web site: www.acep.org/.

American College of Osteopathic Emergency Physicians. 142 E. Ontario Street, Suite 550, Chicago, IL 60611. Web site: www.acoep.org/.

American College of Sports Medicine. 401 W. Michigan St., Indianapolis, IN 46202–3233. Web site: www.acsm.org/.

Web Sites

"Bruises." MedlinePlus. Available online at www.nlm.nih.gov/medlineplus/bruises.html (accessed December 7, 2004).

"Bruises/Contusions." ForensicMD. Available online at www.forensicmed.co.uk/bruises.htm (accessed December 7, 2004).

"Bruises, Ouch!" University of Iowa Health Science Relations. Available online at www.vh.org/adult/patient/familymedicine/prose/bruises.html (accessed December 7, 2004).

[Article by: L. Fleming Fallon, Jr., MD, DrPH]

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For more information on bruise, visit Britannica.com.

contusion

Bleeding in soft tissue resulting from a direct blow with a blunt object. A bruise is usually associated with swelling and oedema. A severe blow or an aggravated bruise can result in dramatic pooling of blood in the area of the bruise (see haematoma). A bruise changes colour, first to blue as the red pigment of haemoglobin loses its oxygen, and then to brown or yellow as the haemoglobin is broken down and reabsorbed. Prevention of effusion of blood from small bruises can be achieved by applying a firm pressure for 3-5 min, followed by a cold compress.

Superficial discoloration due to hemorrhage into the tissues from ruptured blood vessels beneath the skin surface, without the skin itself being broken; called also contusion.

IN BRIEF: A discolored area of the body following an injury.

Katie had a bruise on her knee after she fell off her bicycle.

Tutor's tip: He "brews" (makes tea) good tea, even with the painful bruise (discolored injury) on his hand.

This entry is from Wikipedia, the leading user-contributed encyclopedia. It may not have been reviewed by professional editors (see full disclaimer)

Dansk (Danish)
n. - blåt mærke, slag, kvæstelse
v. tr. - kvæste, såre
v. intr. - blive stødt, få blåt mærke

Nederlands (Dutch)
blauwe plek, kneuzing, kneuzen, pletten

Français (French)
n. - ecchymose, bleu, contusion, meurtrissure, talure (fruit)
v. tr. - faire un bleu à, contusionner, faire un pinçon à (un doigt), abîmer/taler (un fruit), froisser (une laitue), écraser, piler
v. intr. - se taler (un fruit), s'abîmer

Deutsch (German)
n. - Prellung, blauer Fleck, Druckstelle
v. - prellen, quetschen

Ελληνική (Greek)
v. - μωλωπίζω, μελανιάζω, ζουλίζω, μαυρίζω (φρούτο)
n. - μώλωπας, μελανιά

Italiano (Italian)
acciaccare, ammaccare, contusione

Português (Portuguese)
v. - ferir, contundir
n. - contusão (f)

Русский (Russian)
поставить синяк, ушибить, синяк

Español (Spanish)
n. - contusión, cardenal, equimosis, hematoma, magulladura, morado
v. tr. - contusionar, magullar
v. intr. - causar magulladuras o contusiones

Svenska (Swedish)
v. - slå gul o blå, mörbulta
n. - blåmärke, bula

中文（简体）(Chinese (Simplified))
伤痕, 擦伤, 碰伤, 挫伤, 使受伤, 研碎, 受伤

中文（繁體）(Chinese (Traditional))
n. - 傷痕, 擦傷, 碰傷, 挫傷
v. tr. - 使受傷, 研碎
v. intr. - 受傷, 擦傷

한국어 (Korean)
n. - 타박상, 멍
v. tr. - ~에게 타박상을 입히다, ~를 상하게 하다, ~을 부수다
v. intr. - 멍들다, 상하다

日本語 (Japanese)
n. - 打撲傷, 傷, 痛み
v. - 打撲傷を与える, あざを付ける

العربيه (Arabic)
‏(فعل) رض, كدم, ازرق الجلد نتيجه ضربه (الاسم) كدمه, ازرقاق نتيجه ضربه‏

עברית (Hebrew)
n. - ‮חבורה, חבלה, מכה, תפיחה‬
v. tr. - ‮פגע, חבל, היכה, היכה באגרוף‬
v. intr. - ‮התנפח, נפגע‬

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