Bleeding Terminology

Following are some descriptions of bleeding manifestations which can be associated with haematological abnormalities. These lesions are listed in increasing order of severity.

Petechiae
Tiny red spots resulting from blood extravasated from normally healthy blood vessels which have become abnormally permeable (due to a vascular or platelet disorder). Petechiae usually occur in clusters over various parts of the body.

Purpura
These are considered to be confluent petechiae. The same conditions for their appearance apply.

Ecchymosis
"Bruise". An area of extravasated blood arising from trauma to the blood vessels of that area. This can also arise in patients with vascular or platelet disorders.

Epistaxis
"Nose bleeding" This is usually caused by a mild trauma to the blood vessels of the anterior nares, but occasionally is a manifestation of a platelet or vascular abnormality.

Telangiectasis, Angioma
Spots or patches produced by blood in abnormally dilated vessels. These patches will blanch when pressure is applied.

Haematoma
A large bruise throughout the subcutaneous tissue or muscle (caused by extravasation into the perivascular tissue) resulting in changes in the colour and shape of the affected area. A haematoma may also be caused by a defect in the coagulation mechanism such as occurs in haemophilia, leukaemia or pathological fibrinolysis. A haematoma will not blanch when pressure is applied.

Haemarthrosis
This is bleeding into a joint and is usually seen as the result of a severe coagulation disorder eg haemophilia.

Haematuria
This condition presents with blood in the urine and is usually the result of kidney damage/disease or a severe coagulation disorder. New look for June 2003