Bruising, Pediatric

Julie W. Stern, MD Reviewed 10/2018

BASICS

DESCRIPTION

Bruises are the result of extravasation of blood into the skin. Conventional usage often groups petechiae and bruises (or ecchymoses) together as purpura and defines them as follows:...

DIAGNOSIS

General goal is to determine if the cause of the bruising is thrombocytopenia, a coagulation disorder, or an extrinsic factor (such as trauma, infection).

Phase 1: Determine if the history o...

TREATMENT

GENERAL MEASURES

Thrombocytopenia precautions for platelets <20,000 to 50,000—toddlers may need a helmet until platelet count recovers; patients with hemophilia may need restricted activit...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Recurrent and chronic ITP possible

Rapidity of platelet recovery in ITP difficult to predict
Most will recover within 6 to 12 months

DIET

Rarely an...

ADDITIONAL READING

Berntorp E. Progress in haemophilic care: ethical issues. Haemophilia. 2002;8(3):435–438. [View Abstract on OvidInsights]
Buchanan GR. Bleeding signs in children with idiopathi...

CODES

ICD9

924.9 Contusion of unspecified site
782.7 Spontaneous ecchymoses
286.9 Other and unspecified coagulation defects
287.5 Thrombocytopenia, unspecified
459.89 Other specified disorders of circulato...

FAQ

Q: Is hemophilia always diagnosed in the newborn period?
A: No. A familial history may provide clues, but a significant number of patients represent a spontaneous mutation. Additionally, not all bo...

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