• Here is one rough-and-tumble kid.
• He's had delayed wound healing all his life.
• His mother brought him in because he has a scalp wound that just keeps oozing and won't heal.
• She thought he bled more than expected from his circumcision.
• The mother's father had terrible arthritis of his knees and ankles:
• He was wheelchair-bound by the age of 45.
• Died of a 'bleeding ulcer' at age 51.

• Physical exam reveals a healthy, active, afebrile little boy.
• He has a 2 cm laceration of the scalp that is poorly crusted over and slowly oozing red blood.
• He fell while playing, striking his head. He did not lose consciousness.
• The injury is 48 hours old.
• He has a few bruises, but they don't seem excessively large or numerous.
• His neurological exam is within normal limits and there is no papilledema.

Lab to the rescue.                                                                                  Back