Approach to a bleeding child

Abstract

Bruising and bleeding are commonly seen in children. Reasonable differential diagnosis between bleeding disorders and non accidental injury is possible by careful history and examination. The lab tests can be screening tests and special tests. If the screening tests are normal, a thrombin time and platelet aggregation studies should be considered. In individuals with abnormal screening tests, further specific factor work-up should be undertaken for precise diagnosis. In a patient with an abnormal bleeding history and a positive family history, normal screening tests may need further laboratory evaluation. It is challenging for general pediatrician to interpret results of routine screening tests and make decisions to seek for specialist advice. An effort is made to approach a bleeding child by a practicing pediatrician with limited facilities for investigations and when to seek specialist advice.