HEMORRHAGE AND HEMOSTASIS

By/Dr.Abdisamad omar ali

 Hemorrhage
◻ Hemorrhage : is the extravasation of blood from vessels,
is most often the result of damage to blood vessels or
defective clot formation
◻ Capillary bleeding can occur in (trauma, atherosclerosis,
inflammation or neoplastic erosion)
◻ The risk of hemorrhage is increased in a wide variety of
clinical disorders collectively called hemorrhagic
diatheses
◻ These include inherited or acquired defects in vessel walls,
platelets, or coagulation factors
 Clinical consequences of hemorrhage

◻ Hemorrhage may be external or accumulate within a

tissue as a hematoma, which ranges in significance from a
(bruise) to fatal a (massive retroperitoneal hematoma)
resulting from rupture of aortic aneurysm

◻ Large bleeds into body cavities are described variously

according to location (hemothorax, hemopericardium,
hemoperitoneum, or hemarthrosis)

◻ Extensive hemorrhages can occasionally result in jaundice

from the massive breakdown of red cells and hemoglobin
Bruise
Retroperitoneal hematoma
Hemarthrosis
Hemopericardium
Heamothorax
Primary hemostasis
Primary hemostasis
Primary hemostasis
Primary hemostasis
Blood vessel
Endothelial injury
Exposure and adhesion
Activation
Activation
Aggregation
Secondary hemostasis
 Disseminated Intravascular
Coagulation (DIC)
◻ DIC : is widespread thrombosis within the microcirculation that
may be of sudden or insidious onset

◻ It may be seen in disorders ranging from obstetric

complications to advanced malignancy

◻ The widespread microvascular thrombosis consumes platelets

and coagulation proteins (consumptive coagulopathy) and at
the same time fibrinolytic mechanisms are activated

◻ The net result is that excessive clotting and bleeding

DIC