-IBIS-1.5.0-
tx
eyes/ears/nose/throat
epistaxis
diagnoses
definition and etiology
definition: Bleeding from the nose.
etiology: Causes may be local or systemic:
local: a common cause is nose-picking that tears the blood vessels in the anterior nares (Kiesselbach's plexus); other causes include trauma, upper respiratory infection, sinusitis, rhinitis, dryness of the mucous membranes
systemic: malaria, scarlet fever, pertussis, skull fracture, vicarious menses, aspirin usage, hypertension, arteriosclerosis and bleeding disorders such as hemophilia, aplastic anemia, other hereditary coagulopathies, leukemia, Osler-Rendu-Weber syndrome etc.
signs and symptoms
sudden onset of nasal bleeding
lab findings: labwork will only be useful to discern the primary reason for the bleeds; consider coagulation work-up if bleeds are persistent.
course and prognosis
The prognosis depends on the cause, but is generally very good: usually, with pressure on the nasal alae, the bleed will stop in 5-10 minutes. However, recurrences may be frequent until the reason for the bleeds is uncovered and controlled.
Additional conventional treatment includes cautery (chemical or electrical), administration of lidocaine and epinephrine locally, packing nasal cavity with petrolatum-impregnated gauze.
differential diagnosis
investigation of cause
footnotes