Which of the following is a sign of expanding hematoma?

• A. Pulsatile bleeding
• B. Hardening of the tender area
• C. Increased temperature
• D. Shock

Answer: (A)

Pulsatile bleeding is indicative of an expanding hematoma because it suggests that the hematoma is actively growing, likely due to ongoing bleeding within the hematoma itself or from surrounding blood vessels. The pulsatile nature can be a result of arterial involvement, where an artery has been compromised, allowing blood to flow into the hematoma and creating a dynamic, pulsating mass.

When considering the other signs, hardening of the tender area typically indicates that the body is trying to encapsulate the hematoma or there may be some degree of scarring, which can occur in other contexts and is not specific to an expanding hematoma. Increased temperature could suggest inflammation or infection rather than direct expansion of a hematoma itself. Shock, while a serious condition associated with significant blood loss, is not necessarily a direct sign of an expanding hematoma; rather, it indicates a broader systemic response to significant blood volume loss. Therefore, pulsatile bleeding specifically signifies active bleeding and expansion, making it a key indicator in clinical assessment.