Bruises or CONTUSIONS, result from injuries to the deeper layers of the skin or underlying tissues, with variable bleeding but without open wounds. Bruises range from a slight bluish discoloration, due to minimal trauma and haemorrhage, to a large black swelling in more severe cases. Diseases such as HAEMOPHILIA and SCURVY, which reduce COAGULATION, should be suspected when extensive bruises are produced by minor injuries. Bruises change colour from blue-black to brown to yellow, gradually fading as the blood pigment is broken down and absorbed. Bruising in the abdomen or in the back in the area of the kidneys should prompt the examining doctor to assess whether there has been any damage to internal tissues or organs. Bruising in children, especially repeated bruising, particularly on parts of the body not commonly subject to accidental trauma, may be caused by physical abuse (see CHILD ABUSE and NON-ACCIDENTAL INJURY). Adults, too, may be subjected to regular physical abuse.