Trauma: Insights on Bruises, Strangulation, and Healing Time

Regarding trauma?

1.
Doctor, I have a question: My chest was struck multiple times with a fist by my partner, but the injuries only showed minor "abrasions" and "bruises" (2x2 cm and 4x1.5 cm).
How is this possible?
2.
Additionally, I was choked twice by my partner with both hands around my neck and dragged on the floor, which caused me to bite my tongue and experience difficulty breathing.
Only a bruise on the tip of my tongue (0.4x1 cm) was found, but there were no marks on my neck.
How can this be explained? Isn't the neck a very vulnerable area? If there was choking to the point of causing breathing difficulties and being dragged on the floor, especially twice, why are there no visible injuries? Is it possible that I was examined on the same day? Furthermore, I went for another examination within a week, and still, no marks were found on my neck.
What could be the reason for this?
3.
Also, regarding bruises (minor ones measuring 1-2 cm), how long does it typically take for an average person to heal to the point where no marks are visible?
4.
Concerning "contusions" and "strains," are there observable symptoms during a doctor's examination? For example, will there be redness and swelling, or is it just "pain" without any open wounds that would allow the doctor to make a diagnosis?

Lin, 30~39 year old female. Ask Date: 2005/02/07

Dr. Shang Dongfu reply Surgery

Hello, the content of a forensic examination must be objective and based on specific observations or results from medical instruments; therefore, the symptoms described by the patient cannot be used to create a legally admissible record.
The appearance of bruises can last for varying durations, which should be related to the severity of the injury: mild cases may last three to five days, while more severe cases may leave traces of bleeding for a longer period.
Happy New Year!

Reply Date: 2005/02/07

More Info

I'm sorry to hear about your situation. Let's break down your questions regarding trauma, bruises, strangulation, and healing time.

1. Understanding Bruises and Minor Injuries
When you experience trauma, such as being struck by a fist, the body can react in various ways. The fact that you only have minor abrasions and bruises (2x2 cm and 4x1.5 cm) suggests that while the impact was significant, it may not have been enough to cause deeper tissue damage or fractures. Bruises occur when small blood vessels under the skin break, causing blood to leak into the surrounding tissue, which leads to discoloration. The severity of the bruise can depend on several factors, including the force of the impact, the area of the body affected, and individual differences in skin and tissue resilience.

2. Strangulation and Lack of Visible Injuries
Strangulation can be particularly concerning because it can lead to serious internal injuries even if there are no visible marks on the skin. The neck contains vital structures, including the trachea (windpipe) and major blood vessels. In some cases, the pressure applied during strangulation can cause internal injuries that are not immediately visible. The absence of external bruising or injury does not rule out the possibility of damage to the underlying tissues or structures. It's also possible that the force applied was not sufficient to cause visible bruising, especially if the pressure was applied in a way that did not compress the skin directly.

If you experienced difficulty breathing and other symptoms, it's crucial to seek medical attention, as strangulation can lead to serious complications, including airway obstruction or damage to the carotid arteries, which can have long-term effects.

3. Healing Time for Bruises
Generally, small bruises (1-2 cm) can take about 1 to 2 weeks to heal completely. The healing process involves the body reabsorbing the blood that has leaked into the tissues, which can cause the bruise to change color over time—from red to purple, then yellowish as it heals. Factors such as age, overall health, and the location of the bruise can influence healing time.

4. Observing Symptoms of Contusions and Strains
In terms of contusions (bruises) and strains (muscle or tendon injuries), doctors often look for specific symptoms during an examination. Contusions may present as swelling, discoloration, and tenderness in the affected area. Strains may also show signs of swelling and pain, and the affected muscle may feel tight or weak. While there may not be open wounds, the presence of pain, swelling, and tenderness can provide enough information for a doctor to make a diagnosis.
In conclusion, while visible injuries are important for diagnosis, many internal injuries can occur without external signs. If you have ongoing symptoms or concerns about your injuries, it is essential to follow up with a healthcare professional who can provide a thorough evaluation and appropriate care. Always prioritize your health and safety, especially in situations involving potential abuse or trauma.

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