Bruise of mammary glands – the closed traumatic damage of fabrics of chest gland. Most often the bruise of mammary glands occurs in life when falling, road accidents, blows in transport and during the sports. The bruise of mammary glands is followed by pain, formation of the site of consolidation and a hematoma. Diagnosis of a bruise is based on existence of a trauma in the anamnesis, performing ultrasonography of mammary glands, radio thermometry, if necessary – mammographies. Treatment of a bruise of mammary glands is more often carried out conservatively; at a large hematoma its punktsionny aspiration or removal (a sectoral resection of a mammary gland) is carried out.
Bruise of mammary glands
Traumatic injuries of mammary glands can be closed and opened, isolated or combined. Bruises and hematomas of mammary glands belong to the closed injuries. Among open damages the cut, chipped, fire, bitten wounds can meet. In a mammology bruises and other injuries of a breast, despite a superficial arrangement of body, meet infrequently and make 1-2% of all pathology of mammary glands. Injuries of mammary glands can be combined with injuries of a thorax – bruises of edges, fractures of edges and breasts, pheumothorax, gemotoraksy. Any injuries of mammary glands can be complicated by bleeding, suppuration, and also to lead to development of painful shock.
Reasons of injuries of mammary glands
Bruises of mammary glands result from injuries of household character more often – falling on pieces of furniture, casual blows in transport, during the games with children, about door jambs, about a wheel in car accidents etc. Under the influence of the injuring factor integrity of vessels is broken that brings to a blood izlitiya into fabrics. At minor injuries of a mammary gland bleeding usually stops spontaneously. Tissues of mammary glands differ in resistance to direct injuries, however in view of a good innervation of body, bruises can be followed by traumatic shock, especially, if damage falls on paraareolyarny or mamillar area.
Open wounds of mammary glands most often are a consequence of violence (attempt of murder, suicide) or result of a careless prick or falling on a sharp object. As feature of the chipped and cut and bitten wounds serves their contamination microorganisms, resistant to traditional antibacterial medicines, presence of an anaerobic infection, polymorphism of pathogens.
Symptoms of a bruise of mammary glands
As a rule, bruises of mammary glands are followed by formation of a hypodermic or deep hematoma – a limited congestion of blood in soft tissues of a breast. Over time hematomas can resolve, however quite often on their place the fatty necrosis of a mammary gland is formed. Besides, at infection of the blood which streamed in fabric, the probability of suppuration and formation of abscess of a mammary gland is high.
As a result of a bruise of a mammary gland the patient is disturbed by the pains and a swelling in a breast remaining a long time. Sometimes, when traumatizing lacteal channels, there can be allocations from a nipple of transparent character or the blood containing impurity.
On the place of a bruise of a mammary gland, usually there is a site of consolidation which is not dangerous in respect of a malignization. On the other hand, the injury of mammary glands can be a provocative factor of growth of other tumor which still is not revealed yet. In the anamnesis of many patients in whom cancer of mammary glands was found subsequently, breast injuries were noted. Bruises of mammary glands at the nodal mastopathy which is available for the woman are especially dangerous. Replacement of a necrosis of fatty cellulose with cicatricial fabric sometimes leads to retraction of skin, deformation of a breast that also can be accepted for an oncopathology of a mammary gland.
Therefore any bruise of mammary glands, a hematoma, existence of consolidation, change of skin color is a reason for the address to the mammologist and carrying out detailed mammology inspection.
Diagnosis of a bruise of mammary glands
After a bruise it is recommended to perform independent inspection and a palpation of a mammary gland regarding early detection of a hematoma and consolidation. In the course of self-inspection it is necessary to carry out a consecutive palpation of each of sectors of a mammary gland and axillary hollows. It is better to examine skin of chest gland in front of the mirror. At identification of change of skin color, the venous drawing, retraction of a nipple or skin, visual or palpatorny definition of consolidation, a small knot it is necessary to address the expert immediately.
The intramammarny hematoma which is formed at a bruise of a mammary gland leads to increase in volume of a breast and gives to integuments a crimson or cyanotic shade. Over time the hematoma changes coloring and turns pale ("fades").
Quite often it is possible to find consequences of a bruise of a mammary gland in the thickness of fabrics only with the help of tool diagnostics. Therefore the visit to the mammologist is necessary even in the absence of the seen and palpated changes. At a bruise of a mammary gland ultrasonography, radio thermometry, mammography, in not clear situations – KT or MPT of mammary glands is carried out.
When performing ultrasonography of mammary glands traumatic hypostasis in the form of the lowered ekhogennost of fabrics comes to light. Fresh hematomas originally are defined in the form of uniform ekhonegativny structure, however soon in them ekhopozitivny signals – small inclusions of fibrin appear. Rassasyvany hematomas is followed by reduction of its sizes and decrease in an ekhogennost. At an organized hematoma formation of a high ekhogennost with a clear boundary is located.
Mammography at bruises of mammary glands allows to differentiate post-traumatic changes from tumoral new growths. The radio thermometry at a bruise of mammary glands allows to reveal existence of an inflammatory component in the thickness of fabrics.
Treatment of a bruise of a mammary gland
At a bruise of a mammary gland the immobilization of the injured breast and its fixing is made by a bandage at the lifted situation. For the purpose of knocking over of a pain syndrome retromammarny blockade are made. Dry heat, rubbing in of troksevazinovy or geparinovy ointment is applied to acceleration of a rassasyvaniye of a hematoma. Rassasyvany hematomas occurs within 4-6 weeks.
For prevention of suppuration of extensive hematomas antibiotic treatment is appointed. In case of development of post-traumatic abscess its treatment is carried out by the principles of therapy of purulent mastitis with performance of a puncture and drainage of the center. Resort to removal of hematomas at considerable hemorrhages in fabrics of gland or retromammarny cellulose. It is more preferable to carry out evacuation of the streamed blood by a punktsionny method. If on the place of a bruise the organized hematoma, a false cyst, opukholepodobny knot, cicatricial changes was created, performance of a sectoral resection of a mammary gland with macromedicine histology is shown.