EPISTAXIS

SUNCY K CHACKO
M1767
• A hemorrhage from the nose,
referred to as epistaxis, is caused
by the rupture of tiny, distended
vessels in the mucous membrane
of any area of the nose.
• Most commonly, the site is the
anterior septum, where three
major blood vessels enter the nasal
cavity: (1) the anterior ethmoidal
artery on the forward part of the
roof (Kesselbach’s plexus) (2) the
sphenopalatine artery in the
posterosuperior region, and (3) the
internal maxillary branches (the
plexus of veins located at the back
of the lateral wall under the
inferior turbinate).
 ETIOLOGY
•
local or systemic causes, environmental factors, or medications .
Environmental factors -  changes in temperature or humidity,  trigger allergies
Medications- Anticoagulants such as warfarin, platelet aggregation inhibitors, NSAIDs (aspirin and ibuprofen), as well as
homeopathic medications that prolong bleeding (like ginseng and Vitamin E),

 von Willebrand
disease and hemophil
ia A and B
TYPES
 SYMPTOMS
Signs of excessive blood loss include:
• dizziness
• weakness
• confusion
• fainting

DIAGNOSIS
• Blood pressure
• Complete blood count
• Coagulation studies
• Angiography
• Endoscopy
• MRI
• X ray
• If this measure is unsuccessful, additional treatment is indicated. In anterior nosebleeds, the area
may be treated with a silver nitrate applicator and Gelfoam, or by electrocautery.
• Topical vasoconstrictors, such as adrenaline or cocaine (0.5%), and phenylephrine may be
prescribed. If bleeding is occurring from the posterior regions, cotton pledgets soaked in a
vasoconstricting solution may be inserted into the nose to reduce the blood flow and improve the
examiner’s view of the bleeding site.
• Recurrent or persistent anterior epistaxis may need cauterization.