An Approach to the Bleeding Child

Bleeding in a child can be a diagnostic challenge
because of the wide range of possible causes, but
making a specific diagnosis is clinically important
in order to provide appropriate therapy. An excessive bleeding response to commonly encountered
challenges suggests the possibility of an underlying bleeding disorder. Symptoms such as bruising
and epistaxis occur frequently in children without
underlying bleeding disorders, and so determining which child requires further investigation can
be difficult. Even when initial symptoms appear
unimpressive, children with underlying bleeding
disorders may be at increased risk for significant
bleeding associated with surgical procedures or
trauma.
Bleeding disorders can be inherited or acquired, and include coagulation factor deficiencies, platelet deficiencies and/or dysfunctions,
and VWD [1, 2].The evaluation of a child presenting with bleeding should include a comprehensive medical and bleeding history, a complete
family history, a detailed physical examination
and selected laboratory tests as outlined in
algorithm 1