-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