Pediatrics. 2013 Apr;131(4):e1357-73. doi: 10.1542/peds.2013-0196. Epub 2013 Mar 25.
Child abuse might be suspected when children present with cutaneous bruising, intracranial hemorrhage, or other manifestations of bleeding. In these cases, it is necessary to consider medical conditions that predispose to easy bleeding/bruising. When evaluating for the possibility of bleeding disorders and other conditions that predispose to hemorrhage, the pediatrician must consider the child's presenting history, medical history, and physical examination findings before initiating a laboratory investigation. Many medical conditions can predispose to easy bleeding. Before ordering laboratory tests for a disease, it is useful to understand the biochemical basis and clinical presentation of the disorder, condition prevalence, and test characteristics. This technical report reviews the major medical conditions that predispose to bruising/bleeding and should be considered when evaluating for abusive injury.
当儿童出现皮肤瘀斑、颅内出血或其他出血表现时，可能会怀疑虐待儿童。在这些情况下，有必要考虑易出血/瘀伤的医疗条件。在评估出血性疾病和其他易出血的情况时，儿科医生在开始实验室检查之前，必须考虑到儿童的临床表现、病史和体格检查结果。许多医疗条件会导致容易出血。在为疾病开实验室检查之前，了解疾病的生化基础和临床表现、疾病的流行程度以及检查的特点是很有用的。本技术报告回顾了易导致瘀伤/出血的主要医疗状况，在评估虐待性损伤时应予以考虑。
