From the Guidelines
A bruit would be present during a hematoma due to the presence of high-frequency turbulent blood flow through an arterialized vein, as indicated by the presence of a high-frequency bruit on auscultation 1. This occurs when there is an abnormal connection between an artery and vein, typically following vascular access procedures, and is a manifestation of an infiltration or hematoma. The bruit results from the turbulent blood flow through this abnormal connection, which can be heard through auscultation. Some key points to consider include:
- The risk for bleeding and hematoma formation is greatest in the early stages of use of a fistula, particularly in brachiobasilic fistulae 1.
- Hematomas should be treated surgically if they are compromising the lumen of the arterialized vein, producing stenosis 1.
- The presence of a bruit is an important clinical finding that indicates an active vascular abnormality that may require intervention rather than simple observation.
- Patients with this condition may also experience pulsation in the area (a thrill) and the hematoma may not resolve spontaneously due to continued blood flow through the fistula. The clinical significance of a bruit in the context of a hematoma is that it suggests the presence of an underlying vascular abnormality that requires prompt evaluation and treatment to prevent further complications, such as access loss or worsening of the hematoma 1.
From the Research
Presence of Bruit during Hematoma
- A bruit is a vascular sound that can be heard over an artery, indicating turbulent blood flow 2, 3, 4, 5, 6.
- During a hematoma, a bruit may be present due to the disruption of normal blood flow in the affected area.
- The presence of a bruit can be an indication of an underlying vascular injury or anomaly, such as a pseudoaneurysm or an arteriovenous fistula 3, 4, 6.
- However, it is essential to note that the provided studies do not directly address the presence of a bruit during a hematoma, and more research is needed to fully understand this phenomenon.
Related Vascular Complications
- Hemorrhagic transformation is a serious complication that can occur after an ischemic event, and it is associated with various risk factors, including demographic factors, comorbidities, and predictors such as higher NIHSS score and larger infarction size 3.
- Anticoagulant therapy can increase the risk of bleeding, and the risk of bleeding associated with intravenous anticoagulants, such as heparin, can be significant 4, 5.
- The management of bleeding in vascular surgery poses a significant haemostatic challenge, and a restrictive transfusion trigger for red cells and prophylactic antifibrinolytic use are recommended 6.
Importance of Further Research
- Further studies are needed to investigate the relationship between hematoma and bruit, as well as the underlying mechanisms and risk factors associated with this phenomenon 2, 3, 4, 5, 6.
- Research into the management of bleeding in vascular surgery and the use of anticoagulant therapy can help inform clinical practice and improve patient outcomes 4, 5, 6.