After decades of working closely with our personal injury clients, we came to realize that people often overlook or ignore bruises after an accident. The tendency is to only consider injuries such as fractures, lacerations, and burns as “serious.” It is important to understand that bruises mean after an accident and when can bruises be warning signs of hidden injuries.

What is a bruise?

A bruise is a collection of blood under the skin. People bump into things, fall down, and create these small or large dark patches. Typically, the blood is reabsorbed into the bloodstream, and the body is able to heal itself. But what if bruises indicate an injury that is more concerning than a small uncomfortable bump on the skin?

Areas of the Body to Watch for Bruising After An Accident

After a traumatic injury, bruising in certain parts of the body may indicate more severe problems. Emergency room doctors may examine these areas after an accident to quickly screen the severity:

Head

Behind ears (“Battles sign”):

  • Used to diagnose a basilar skull fracture. Multiple bones in the skull are involved in this fracture which causes a high risk for internal bleeding. The smaller bruises signal a much bigger problem inside the head.
  • Discoloration is typically seen 1-3 days after the trauma.
  • Other signs associated with this type of skull fracture are fluid leaking from nose, nausea, and/or vomiting.
  • Can result from head injuries related to falls, assaults, or motor vehicle accidents. 

Around eyes (“Racoon eyes”): 

  • Can also be a sign of a basilar skull fracture as described above. Bruising can signal facial trauma.
  • Discoloration is typically seen 1-3 days after the trauma.
  • CT scans are completed to diagnose this injury.
  • Treatment is based on severity of the injury and can include observation in a hospital, antibiotics, or even neurosurgery. 

illustration of head bruises

 

Abdomen:

Around the belly button/umbilicus (“Cullen’s sign”):

  • Bruising may indicate bleeding inside the abdomen. The aorta, the large vessel coming directly from the heart within the abdomen, can tear or rupture during trauma, often resulting in a sudden emergency.
  • Severe abdominal pain usually occurs where there is such a tear, and this must be treated immediately as it can be fatal. 

Lower back/flank area (“Grey Turner’s”):

  • Can indicate that there may be bleeding behind the peritoneal cavity that surrounds the organs of the abdomen.

Call 911 in either of these two cases or present immediately to the emergency room for evaluation. There are many organs in the abdomen such as the spleen and liver that can bleed very easily when significant trauma has occurred, and surgical intervention may be necessary.

image of abdomen bruises

 

Chest/Torso

Seatbelt sign:

  • Bruising over the chest and abdomen (where the seatbelt is located) following a motor vehicle accident can indicate the severity of the impact. These marks alert medical professionals to investigate for further damage to the internal organs. 
  • Bruising in this area can also be an alert to the following:
    • Aortic or carotid artery injuries
    • Rib, sternum, or collar bone fractures
    • Injury to the heart, lungs, or esophagus
    • Injury to any organ/muscle in the abdomen including but not limited to diaphragm; liver; pancreas; spleen; female organs, bowel; and pelvic bone.
Arm/leg/joint:
  • Any prolonged use of the body’s muscles and bones can cause further damage if an injury has not been diagnosed.
  • Any abnormal or prolonged bruising over these areas with pain and decreased range of motion should be evaluated by a medical provider as tendons and ligaments can withstand a lot of use even after injury.

Don’t Ignore the Signs of Bruising After an Accident

This list is by no means exhaustive of all the injuries that can arise from an accident. The skin, the body’s largest organ, and the signs and symptoms it presents can be very confusing. Bruising of the skin can give quick clues to injuries that may not be seen by the naked eye.

Premier Law Group wants to share this valuable information, so victims do not ignore the signs of possible internal injuries, resulting in treatment delay and even more serious damage. We encourage you to consult your doctor if you have any concerns related to bruising after an accident.

Treatment of serious injuries can be costly. If your injury is a result of the negligence of another, it is important to consult with a lawyer who specializes in personal injury law. The attorneys at Premier Law Group are the experts in helping injury victims in the Seattle-Bellevue area receive just compensation for their injuries. Contact us at 206-285-1743 for a free case evaluation.

References

Alhassan N. Altered Mental Status. Nada’s Notes & Summaries: Simplifying medicine one summary at a time. https://nadanotes.com/2018/03/31/altered-mental-status/. Accessed March 9, 2020.

Greenwood M, Macleod RI, Jay RH, et al. 9 Neurology and special senses. Pocket Dentistry. https://pocketdentistry.com/9-neurology-and-special-senses/. Published January 5, 2015. Accessed March 9, 2020.

Amarakone, K. (2019). SEAT BELT INJURIES. Retrieved March 10, 2020, from https://dontforgetthebubbles.com/seat-belt-injuries/

Heegaard WG. Skull fractures in adults. UpToDate. https://www.uptodate.com/contents/skull-fractures-in-adults. Published May 21, 2019. Accessed March 9, 2020.

Kendall JL. Evaluation of the adult with abdominal pain in the emergency department. UpToDate. https://www.uptodate.com/contents/evaluation-of-the-adult-with-abdominal-pain-in-the-emergency-department. Published January 14, 2020. Accessed March 9, 2020.

Legome, E. (2019, December 12). Initial evaluation and management of blunt thoracic trauma in adults. Retrieved March 10, 2020, from https://www.uptodate.com/contents/initial-evaluation-and-management-of-blunt-thoracic-trauma-in-adults

Sawyer, N. (2018). GrepMed. Retrieved from https://www.grepmed.com/images/1489/seatbeltsign-seatbelt-clinical-trauma-em