Abdominal Impact: Should You Worry About Internal Bleeding?

Abdominal trauma

I accidentally bumped into the edge of a table while operating a chair yesterday, and now I have a persistent feeling of bloating and pain in my abdomen (similar to the sensation of drinking too much water).
However, I do not have any symptoms such as blood in urine or stool, or dizziness.
Could this be internal bleeding? Should I go to the hospital immediately?

LiLi, 20~29 year old female. Ask Date: 2017/04/05

Dr. Chen Jiaming reply Surgery

Abdominal contusion can commonly lead to intra-abdominal bleeding.
Aside from high-speed, high-energy impacts (such as in car accidents), everyday household items typically require sharper or pointed impacts to have a higher chance of causing such injuries (like hitting a corner of a table).
Additionally, the impact must directly affect organs that are prone to intra-abdominal bleeding, such as the liver (located in the right upper abdomen) or the spleen (located in the left upper abdomen).

In young individuals, if intra-abdominal bleeding occurs, symptoms may include palpitations (rapid heartbeat), progressively worsening abdominal pain, diarrhea or intestinal cramps (due to blood irritating the intestines), and dizziness upon standing or lying down.
Generally, the time from injury to the onset of clinical symptoms is critical; the hours from your inquiry to my response could be sufficient for you to develop signs of shock.

More superficial contusions typically result in bruising of the abdominal wall muscles, similar to the bloating pain you described.
In the initial two days, applying ice and resting (to minimize the use of abdominal muscles) is recommended, while avoiding local massage therapy.
Most cases can resolve on their own within two weeks.
However, if you remain concerned or if symptoms are severe, it would be advisable to visit the emergency department for a quick abdominal ultrasound to rule out any serious issues.

Reply Date: 2017/04/05

More Info

When experiencing abdominal pain following a blunt force impact, such as hitting your abdomen against a table edge, it is essential to assess the situation carefully. The symptoms you describe—persistent abdominal bloating and discomfort—can be concerning, but the absence of more severe symptoms like blood in urine or stool, dizziness, or fainting is a positive sign.

Internal bleeding can occur after trauma, especially if the impact is significant enough to damage internal organs or blood vessels. Common signs of internal bleeding include:
1. Abdominal Pain: This can range from mild discomfort to severe pain, depending on the extent of the injury.

2. Swelling or Distension: A feeling of fullness or bloating in the abdomen can indicate fluid accumulation, which may be due to bleeding.

3. Changes in Vital Signs: Symptoms like dizziness, weakness, or fainting can indicate significant blood loss.

4. Blood in Stool or Urine: This is a more direct sign of internal bleeding, particularly from the gastrointestinal tract or urinary system.

Given your current symptoms of abdominal bloating and discomfort without any alarming signs, it is still advisable to monitor your condition closely. Here are some steps you can take:
1. Rest: Avoid any strenuous activities that could exacerbate your symptoms.

2. Ice Application: Applying ice to the affected area may help reduce swelling and alleviate pain.

3. Hydration: Ensure you are drinking enough fluids, but avoid excessive intake that could worsen the bloating sensation.

4. Pain Management: Over-the-counter pain relievers may help, but be cautious with medications like aspirin or ibuprofen, as they can increase the risk of bleeding.

However, if you notice any of the following symptoms, you should seek medical attention immediately:
- Severe or worsening abdominal pain
- Signs of shock (such as rapid heartbeat, shallow breathing, or confusion)
- Blood in urine or stool
- Persistent vomiting or nausea
- Dizziness or fainting
In the absence of these severe symptoms, you may not need to rush to the hospital, but it is wise to consult with a healthcare professional, especially if your symptoms persist or worsen over the next few hours. A medical evaluation may include a physical examination and possibly imaging studies, such as an ultrasound or CT scan, to rule out internal injuries or bleeding.

In summary, while your current symptoms do not immediately suggest internal bleeding, it is crucial to remain vigilant. If your condition changes or if you develop any concerning symptoms, do not hesitate to seek medical care. Your health and safety should always be the top priority.

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Hello, I have responded to your questions. Wishing you good health.