Table of Contents

HK J Paediatr (New Series)
Vol 5. No. 1, 2000

HK J Paediatr (New Series) 2000;5:65-69

Personal Practice

Screening for Bleeding Tendency in Suspected Child Abuse

ACW Lee, ESK Ma


Abstract

Children who have been physically abused or victims of Munchausen syndrome by proxy may occasionally be complicated by coagulopathy. Specific bleeding diathesis presenting as suspected child abuse is rarely reported in the medical literature. More commonly, however, screening tests are used to exclude an underlying bleeding tendency in suspected cases of child abuse. Under most circumstances, ordering a platelet count, prothrombin time and activated partial thromboplastin time would be sufficient for clinical differential diagnosis or medico-legal purposes. Bleeding time may be included if a platelet function defect is suspected. However, the value of a thorough history and comprehensive physical examination cannot be overemphasized. The identification of a bleeding tendency does not exclude child abuse. A maltreated child who presents with bruises that are clearly indicative of an inflicted injury does not require coagulation screening unless indicated otherwise.

Keyword : Child abuse; Haemostasis; Coagulopathy; Thrombocytopenia


Abstract in Chinese

 
 

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