ABSTRACT
The hemostatic system involves a complex interplay between the blood vessel wall, platelets, and multiple procoagulant and anticoagulant factors in the peripheral blood. This complex defense mechanism prevents excessive hemorrhage and helps localize repair to the site of injury without prolonged obstruction of blood flow. The process of clot dissolution (fibrinolysis) is initiated at the same time that the clot is forming. Fibrinolysis is mediated by plasmin, which circulates as the inactive proenzyme plasminogen. A detailed examination of all body systems should be performed to identify all sites of hemorrhage. Common sites of hemorrhage due to bleeding disorders include eyes, skin, mucous membranes, joints, urinary tract, lungs, and pleural and peritoneal cavity. Fibrinogen levels can be semiquantitatively measured with heat precipitation, although the test is subjective and not highly reliable.
