Symptoms in SSPs tend to be more severe than in PSPs, as the unaffected lungs are generally unable to replace the loss of function in the affected lungs. Hypoxemia (decreased blood-oxygen levels) is usually present and may be observed as cyanosis (blue discoloration of the lips and skin). Hypercapnia (accumulation of carbon dioxide in the blood) is sometimes encountered; this may cause confusion and – if very severe – may result in comas. The sudden onset of breathlessness in someone with chronic obstructive pulmonary disease (COPD), cystic fibrosis, or other serious lung diseases should therefore prompt investigations to identify the possibility of a pneumothorax.Traumatic pneumothorax most commonly occurs when the chest wall is pierced, such as when a stab wound or gunshot wound allows air to enter the pleural space, or because some other mechanical injury to the lung compromises the integrity of the involved structures. Traumatic pneumothoraces have been found to occur in up to half of all cases of chest trauma, with only rib fractures being more common in this group. The pneumothorax can be occult (not readily apparent) in half of these cases, but may enlarge – particularly if mechanical ventilation is required. They are also encountered in people already receiving mechanical ventilation for some other reason.Upon physical examination, breath sounds (heard with a stethoscope) may be diminished on the affected side, partly because air in the pleural space dampens the transmission of sound. Measures of the conduction of vocal vibrations to the surface of the chest may be altered.
Often the result of strain, including sneezing, coughing, vomiting or other kind of strain
Nose

Epistaxis – nosebleed
Mouth
Tooth eruption – losing a tooth
Hematemesis – vomiting fresh blood
Hemoptysis – coughing up blood from the lungs
Lungs
Pulmonary hemorrhage
Gastrointestinal
Upper gastrointestinal bleed
Lower gastrointestinal bleed
Occult gastrointestinal bleed
Urinary tract
Hematuria – blood in the urine from urinary bleeding
Gynecologic
Vaginal bleeding
Postpartum hemorrhage
Breakthrough bleeding
Ovarian bleeding – This is a potentially catastrophic and not so rare complication among lean patients with polycystic ovary syndrome undergoing transvaginal oocyte retrieval. Anus
Melena – upper gastrointestinal bleeding
Hematochezia – lower gastrointestinal bleeding, or brisk upper gastrointestinal bleeding
Vascular
Ruptured aneurysm
Aortic transection
Iatrogenic injury

Causes
Bleeding arises due to either traumatic injury, underlying medical condition, or a combination. Traumatic injury
Traumatic bleeding is caused by some type of injury. There are different types of wounds which may cause traumatic bleeding. These include:
Abrasion – Also called a graze, this is caused by transverse action of a foreign object against the skin, and usually does not penetrate below the epidermis. Excoriation – In common with Abrasion, this is caused by mechanical destruction of the skin, although it usually has an underlying medical cause. Hematoma – Caused by damage to a blood vessel that in turn causes blood to collect in an enclosed area. Laceration – Irregular wound caused by blunt impact to soft tissue overlying hard tissue or tearing such as in childbirth. In some instances, this can also be used to describe an incision. Incision – A cut into a body tissue or organ, such as by a scalpel, made during surgery.