Symptoms of internal bleeding


The causes of internal bleeding are as varied as the signs and symptoms. Some are caused by an external force, such as a blow to the body, while others occur within the body due to a disease or structural weakness.


Trauma is one of the more common causes of internal bleeding. It can include various types of injuries:1

  • Penetrating trauma: This is when an object enters the body, such as a knife, broken glass, shrapnel, or a bullet.
  • Blunt trauma: This can range from knocks and punches, which may not cause obvious symptoms at first, to high-velocity impacts, which often do.
  • Deceleration injuries: This commonly occurs in car crashes. When a speeding vehicle abruptly stops, it can cause vessels and organs to rupture or detach from one another.
  • Fractures: Some fractures bleed more than others. Fractures of the long bones of the arm, leg, and pelvis can cause major blood loss. Bone fragments can also tear blood vessels.


An aneurysm is a bulge in a blood vessel caused by a weakness in the blood vessel wall.  This can cause the vessel to rupture. Sometimes, the rupture of an aneurysm happens with intense activity. At other times, it can occur for no apparent reason during rest or sleep.

Aneurysms can occur in any blood vessel, although they are more common in the brain (cerebral aneurysm) or the aorta, either in the chest (ascending or descending thoracic aortic aneurysm) or abdomen (abdominal aortic aneurysm).

Bleeding Disorders

Bleeding disorders such as hemophilia can place a person at increased risk of bleeding, including internal bleeding. This is caused when blood does not clot as it should, due either to the lack of blood cells called platelets or proteins called clotting factors.

The overuse of certain drugs can have the same effect. This includes blood thinners like warfarin and anti-platelet drugs like Plavix (clopidogrel). Even nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin and Advil (ibuprofen) can cause internal bleeding if used in excess, especially if you have a peptic ulcer or any other condition that causes gastric (stomach) bleeding.

Hemorrhagic Fevers

A less common cause of internal bleeding is viral hemorrhagic fevers. Certain viruses can cause small blood clots to form in blood vessels throughout the body. By doing so, there are fewer platelets available to stop bleeding.4

Common symptoms include vomiting, diarrhea, muscle pain, tiny red or purple spots on the skin (called petechiae), bleeding, and a drop in blood pressure.4

There are many viral diseases that can cause internal bleeding, most of which are confined to Africa. These include:4

  • Chikungunya fever
  • Dengue fever
  • Ebola virus
  • Hantavirus
  • Lassa fever
  • Rift Valley Fever
  • Yellow fever

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