Conservative Management of Internal Bleeding Following Trauma in an Immune Thrombocytopenic Purpura Child with COVID-19 Infection

Abstract

Immune thrombocytopenic purpura (ITP) usually presents with minor bleeding such as petechiae and purpura. Rarely, life-threatening events such as intracranial and intra-abdominal bleeding can be occurred. Here, we present a case of a 9-year-old patient who presented to the emergency department after being hit by a motorcycle with a decrease of consciousness and symptoms of shock. On physical examination, a large abdominal bruise was seen, and it was proved by FAST to confirm abdominal bleeding. Sign of shock, decrease of hemoglobin, and a free fluid in Morison’s pouch were found by the FAST examination and led to establish abdominal bleeding diagnosis. The presence of bleeding in ITP patient, especially children, can be safely managed with observation alone. This case highlights the life-threatening condition, abdominal bleeding in severe thrombocytopenia, successfully treated with a conservative treatment strategy.

Keywords

• covid-19
• conservative management
• internal bleeding
• immune thrombocytopenic purpura