I was recently involved in a motorbike accident. I felt fine and didn’t see a doctor. However, I have developed intense stomachache and was just wondering if I could be experiencing mild internal bleeding. 

Paul

Dear Paul,

After a blunt injury, abdominal pain may not be felt initially. However if internal bleeding occurs and the blood accumulates, one starts feeling pain. There may be associated nausea, vomiting, bluish discoloration around umbilicus, pain on touching, one or more of these signs. This can be diagnosed by imaging techniques like abdominal ultrasound and CT scan. This is a curable condition, where the surgeon can put a drain to evacuate the blood or in more severe cases, open the abdomen to drain it. A cyst can form in mesentry or bowels after trauma due to hematoma being formed and subsequent resorption of blood. This can also cause abdominal pain some days after trauma.

One may develop post traumatic stress disorder (PTSD) following an accident. This may cause pain as one of the manifestations due to the fear and anxiety, although no physical injury may be present. 

You may undergo ultrasound examination to exclude internal bleeding.

Dr Rachna Pande  is a specialist in internal medicine at Ruhengeri Hospital