Discovering unexplained bruising on your stomach can be alarming. You might wonder what causes this abdominal bruising. Sometimes, abdominal bruising comes from minor issues. For instance, rectus sheath hematomas can cause abdominal bruising. They can happen due to:
A tendency to bleed
Use of blood thinners
Damage to blood vessels from physical injury
Surgical complications
Intense muscle contractions (e.g., during heavy retching, vomiting, or straining)
However, unusual bruising can also signal serious underlying health issues. This blog helps you understand potential causes and identify urgent warning signs. Always consult a doctor for any persistent or concerning abdominal bruising. Do not self-diagnose.
Key Takeaways
Unexplained stomach bruises can be minor or serious. Always see a doctor for any concerns.
Many things cause stomach bruises. These include small bumps, certain medicines, or not enough vitamins.
Serious causes of stomach bruises include blood problems, organ issues, or weak blood vessels.
Look for urgent warning signs. These include bruising around your belly button, severe pain, or fever.
See a doctor if a bruise does not go away, gets bigger, or appears without injury. Also see a doctor if you have other symptoms.
Common Causes
Minor Trauma
Sometimes, simple bumps or impacts cause abdominal bruising. You might not even remember the exact moment of injury. For example, a tight seat belt during a sudden stop can cause lap belt bruising. Bicycle handlebar injuries or other seat belt injuries can also lead to bruising on your stomach.
Even minor trauma can sometimes cause an abdominal hematoma, which is a collection of blood outside blood vessels. Acute gastric dilatation, a swelling of the stomach, can also happen after relatively minor abdominal trauma. These small incidents are common causes of random bruising.
Medication Effects
Certain medications increase your risk of bruising. These drugs affect how your blood clots. Anticoagulants, also known as blood thinners, are a major culprit. Examples include warfarin (Jantoven), dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis), and heparin. These medicines interfere with your blood’s normal clotting process.
This makes you bruise more easily. Even a small bump can result in an abdominal hematoma when you take these medications. Anti-platelet agents like aspirin and clopidogrel (Plavix) also increase bruising. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen sodium can contribute to random bruising. Corticosteroids, some antibiotics, and certain antidepressants are other risk factors. Even dietary supplements like ginkgo biloba can be causes of random bruising.
Nutritional Deficiencies
Your body needs certain vitamins for healthy blood clotting. A lack of these vitamins can lead to easy bruising. Vitamin K is crucial for blood clotting. Your body uses it to make proteins called clotting factors. Without enough Vitamin K, your liver cannot produce these factors effectively.
This means your blood does not clot well, leading to abdominal bruising. Vitamin C also plays a role. It helps keep your blood vessels strong. A severe lack of Vitamin C (scurvy) can weaken blood vessels, making them more prone to breaking and causing random bruising. These deficiencies are important risk factors for unexplained bruising.
Serious Causes
Sometimes, unexplained abdominal bruising points to more serious health problems. These conditions affect your body’s ability to clot blood or maintain healthy blood vessels.
Blood Disorders
Certain blood disorders make you bruise easily. Hemophilia and von Willebrand disease are examples of a bleeding disorder. These conditions prevent your blood from clotting correctly.
For von Willebrand disease, you often have a personal or family history of bleeding. Doctors diagnose it by checking for a decrease in functional von Willebrand factor activity. Levels below 30 IU per dL confirm the diagnosis.
This means you are at high risk for an abdominal hematoma. Acute lymphoblastic leukemia also causes easy abdominal bruising. It is a type of cancer that affects blood cells. These conditions are significant risk factors for developing an abdominal hematoma without clear injury. You might notice random bruising more often.
Organ Dysfunction
Your organs play a vital role in blood clotting. Liver disease, for example, impairs the production of clotting factors.
Your liver makes these proteins, especially those that depend on vitamin K. When your liver is sick, it cannot make enough of them. This leads to a clotting disorder. You become more prone to an abdominal hematoma. Kidney disease can also affect your blood’s ability to clot, increasing your risk for an abdominal hematoma and general abdominal bruising.
Autoimmune Conditions
Autoimmune conditions can also cause unexplained abdominal bruising. Lupus is one such condition. It causes inflammation in your blood vessels. It also leads to low platelet counts, a condition called thrombocytopenia.
Platelets are tiny blood cells that help your blood clot. Low numbers mean you bruise easily and might develop an abdominal hematoma. Wiskott-Aldrich syndrome is another autoimmune condition. It causes abnormal platelets, leading to easy abdominal bruising and a higher chance of an abdominal hematoma. This is another type of bleeding disorder. You might see random bruising appear frequently.
Vascular Issues
Problems with your blood vessels can also cause an abdominal hematoma. Connective tissue disorders weaken your blood vessels. This makes them fragile. You can get an abdominal hematoma from even minor impacts.
Conditions like venous insufficiency and varicose veins are also risk factors. High blood pressure or weakened vein walls can cause an abdominal hematoma. Achenbach syndrome involves fragile blood vessels, often in your fingers or toes, but it shows how weak vessels lead to random bruising. This is a type of clotting disorder where vessel integrity is compromised.
Urgent Warning Signs
Abdominal Bruising: Specific Signs
When you notice unusual abdominal bruising, certain specific signs demand immediate attention. One critical indicator is Cullen’s sign. This appears as superficial edema with bruising, also known as periumbilical ecchymosis, in the fatty tissue around your belly button. You see bluish discoloration or bruising around your navel. Cullen’s sign often indicates severe internal bleeding.
For example, it can point to hemorrhagic pancreatitis or a ruptured ectopic pregnancy. It suggests retroperitoneal hemorrhage. This type of abdominal bruising is a serious concern. Other urgent causes include ruptured abdominal aortic aneurysm (AAA), trauma, or a perforated duodenal ulcer. Another serious sign is an abdominal hematoma. This is bleeding within your abdomen or on your abdominal wall. You might experience sudden, sharp abdominal pain that does not spread. You may also feel nausea and vomiting. In rare cases, you might have low blood volume, a rapid heart rate, and rapid breathing. Sometimes, you might notice a firm, localized lump in your abdominal wall. This lump does not throb with your pulse.
Doctors call this the Fothergill sign. This abdominal hematoma can be a significant cause of your abdominal bruising. The Fothergill sign means a lump in your abdomen does not move across the belly’s midline. It also does not change when you flex your abdominal muscles. This abdominal hematoma needs medical evaluation. If you see bruising on your flanks, Grey Turner’s sign, which is bruising on your sides, also suggests internal bleeding. These are important abdominal bruising indicators.
Accompanying Pain
Severe, sudden, or spreading abdominal pain often accompanies serious abdominal bruising. If you experience sharp, intense pain along with your abdominal bruising, seek medical help.
This pain can indicate internal bleeding or organ damage. An abdominal hematoma often presents with sudden, sharp abdominal pain. These signs and symptoms together are a red flag.
Systemic Symptoms
Beyond the bruise itself, you might experience other systemic symptoms. These are urgent warning signs. If you have a fever, chills, or unexplained weight loss, these are concerning. Fatigue and general malaise, a feeling of being unwell, also point to a serious issue.
A rapidly expanding large bruise with severe pain is an urgent warning sign. You might also have difficulty breathing, severe swelling, or other signs of internal bleeding.
These include dizziness, fainting, or blood in your vomit or stool. Multiple unexplained bruises appearing suddenly, especially with tiny red spots (petechiae) or bleeding from your gums or nose (mucosal bleeding), are also serious signs and symptoms.
If you notice signs of infection near the bruise, such as increasing redness, warmth, or pus, along with a fever, you need prompt medical attention. These are all urgent warning signs that require immediate medical evaluation.
Skin Changes
You should also pay attention to specific skin changes on your abdomen. Cullen’s Sign, for instance, shows bluish discoloration or bruising around your belly button. This abdominal bruising suggests retroperitoneal hemorrhage. It can indicate a ruptured ectopic pregnancy, acute pancreatitis, or a ruptured abdominal aortic aneurysm (AAA).
These are all serious conditions that can cause an abdominal hematoma. Another important skin change is Caput Medusae. This appears as varicose veins radiating from your umbilicus. It signifies portal hypertension. Conditions like cirrhosis or severe liver disease can cause this.
An abdominal hematoma can also cause visible swelling or bloating of your abdomen. You might notice changes in the color or texture of your skin around the abdominal bruising. These are all critical signs and symptoms.
When To See A Doctor
You should always pay close attention to any abdominal bruising that does not go away. If you notice a bruise that keeps coming back in the same place, it warrants a visit to your doctor.
While bruises can swell and worsen in the first few days, symptoms should gradually diminish afterward. If you experience severe or increasing pain and swelling, you should consult a doctor. This persistent abdominal bruising could signal an underlying issue that needs medical attention. Do not ignore an abdominal hematoma that lingers or reappears.
Persistent Bruises
If you have abdominal bruising that does not fade within a few weeks, or if it frequently reappears in the same spot, you need to see a doctor.
A persistent abdominal hematoma can indicate a chronic issue or ongoing internal bleeding. You should not dismiss these signs.
Large Or Spreading Bruises
An unusually large bruise on your stomach is a clear sign to seek medical advice. If you see abdominal bruising that rapidly grows or spreads, especially if it appears without a clear injury, you need to see a doctor. A bruise that expands quickly can indicate significant internal bleeding or a growing abdominal hematoma.
This type of abdominal bruising requires prompt evaluation to determine its cause and prevent further complications. You should not wait if you observe a large or spreading abdominal hematoma.
Bruises Without Injury
Discovering bruises on your stomach without any memory of an injury is a significant warning sign. Many factors can cause random bruising when you have not experienced trauma. Vitamin deficiencies, such as a lack of vitamin K or vitamin C, can lead to easy bruising. Vitamin K deficiency affects blood clotting, while severe vitamin C deficiency (scurvy) can also cause unexplained abdominal bruising.
Thrombocytopenia, a low blood platelet count, hinders your body’s ability to control bleeding, leading to random bruising. Autoimmune conditions like lupus can cause thrombocytopenia, making bruising more likely. Rheumatoid arthritis and some of its medications can also lead to this condition.
Cancers affecting the blood, like leukemia, commonly cause unexplained and easy bruising. You might see bruises in unexpected places, multiple bruises, or bruises that take longer to heal. Sepsis, a severe bodily reaction to an infection, can lower your platelet count, resulting in easy random bruising.
Certain medications and supplements also contribute to bruising without injury. Anticoagulants, nonsteroidal anti-inflammatory drugs (NSAIDs), and corticosteroids can reduce your blood’s ability to clot. Bleeding or clotting disorders, such as hemophilia, thrombocytopenia, or factor V deficiency, cause bruising due to impaired blood clotting.
Sepsis can lead to tiny blood spots (petechiae) or purple areas (purpura) that can form larger bruises. Liver or kidney disease can also cause easy bruising. Liver damage impairs the production of blood clotting proteins.
Kidney disease can lead to easy bruising due to loss of skin elasticity. Medications for these conditions can also affect clotting. Cancer treatments like chemotherapy can lower your platelet count.
Rare conditions like Bernard-Soulier syndrome, an inherited blood clotting disorder, can also cause easy bruising. If you notice an abdominal hematoma without a known cause, you must consult a doctor.
Bruises With Other Symptoms
When abdominal bruising appears with other concerning symptoms, you need immediate medical consultation. If you experience severe swelling of the skin within 30 minutes of an injury, alongside bruising, it may indicate a sprain or fracture requiring a doctor’s treatment.
Bruising can signify various injuries, including sprains, fractures, and damage to tendons and ligaments, all of which require medical attention. You should seek help if you have abdominal bruising accompanied by another injury, such as a broken bone. Bruising coupled with swelling and extreme pain, especially if you take blood-thinning medication, is also a serious concern.
If you experience severe fatigue, dizziness, or unexplained weight loss along with your abdominal bruising, these are urgent warning signs. Bruising in uncommon areas, such as your abdomen or back, especially when combined with other symptoms, also warrants a medical evaluation. An abdominal hematoma accompanied by these systemic signs needs prompt attention.
Diagnosis And Treatment
Medical Evaluation
When you discover unexplained abdominal bruising, you need a thorough medical evaluation. Your doctor will ask about your medical history. They will want to know when your abdominal bruising started. You will discuss any other symptoms you have. Your doctor will ask about past bleeding or bruising episodes.
They will review your current medications. Your doctor will also ask about your family’s health history. This helps them find conditions that cause easy bruising. A physical exam follows.
Your doctor will check your entire skin surface for more abdominal bruising. They will look for signs of internal bleeding. They will check your abdomen for any lumps or tenderness. This comprehensive check helps your doctor understand the cause of your abdominal hematoma.
Lab Tests
Your doctor will order lab tests. These tests help identify the cause of your abdominal bruising. A complete blood count (CBC) checks your blood cells. It can show low platelet levels. Platelets help your blood clot. A coagulation panel measures how fast your blood clots. This includes PT-INR and aPTT.
Test | Normal Value |
|---|---|
PT (seconds) | 10-13 seconds |
INR | 0.8 – 1.2 |
These tests help identify absent or low clotting factors. You may also get a fibrinogen test. If your doctor suspects an inherited disorder, you might get genetic tests. These look for specific clotting factor issues. Liver and kidney function tests also help rule out organ dysfunction. These tests help pinpoint the reason for your abdominal hematoma. |
Imaging Studies
Sometimes, your doctor needs to see inside your body. Imaging studies help find internal injuries or an abdominal hematoma. A CT scan is very useful. It can detect blood in your abdominal cavity. This is called hemoperitoneum.
A CT scan can also show active bleeding. It helps locate the exact bleeding site. If you have severe abdominal bruising, especially with patterned abrasions, a CT scan is indicated.
It can reveal injuries to organs like your spleen, liver, or kidneys. An MRI or ultrasound of your abdomen can also provide detailed images. These help your doctor diagnose the cause of your abdominal hematoma.
Treatment Approaches
Treatment for your abdominal bruising depends on its cause. Your doctor will tailor a plan for you. If a medication causes your abdominal hematoma, your doctor might adjust your dosage.
For nutritional deficiencies, you might need supplements. For example, if you have a vitamin K deficiency, you will take vitamin K supplements. You might also eat more leafy green vegetables.
In severe cases, you might receive fresh frozen plasma. This provides clotting factors. Sometimes, you just need observation. Other times, you might need medication or even surgery. For a large abdominal hematoma, surgery might be necessary. Always follow your doctor’s advice for your abdominal hematoma.
Unexplained bruises on your stomach always need serious attention. You should have a medical professional evaluate them. We discussed causes from minor trauma and medication effects to serious blood disorders and organ dysfunction. These include urgent warning signs like Cullen’s sign.
