Summary:
Hemostasis is a complex multistage cascade of enzyme reactions, where the first impulse is the
damage to endothelium integrity and the result is the development of a thrombus with simultaneous
triggering of anticoagulant and fibrinolytic activity. The original theory of coagulation cascade
as a linear enzyme reaction has been replaced by the model of an active network of simultaneously
proceeding feed-back interactions. The tissue factor plays a key role in initial
activation. The examination procedure of bleeding disorders in children includes, at the first place,
anamnesis and physical examination. The examination of thrombocyte number is the particular
coagulation test sufficient of rapid differential diagnosis within the framework of a complex
blood count, activated partial prothrombine test and prothrombine time. Other tests should be
indicated specifically on the basis of clinical suspicion. A flat (general) laboratory coagulation
screening of children before adenotomy and, especially, the healthy children before a planned
surgical intervention appears to be questionable under the present knowledge. Therefore, a standardized
anamnesis and physical examination should be given priority.
Key words:
coagulopathy, pediatrics, examination, operation, adenotomy
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