A Study on 615 Cases of Idiopathic Epistaxis

Epistaxis is one of the most common complaints encountered in the field of otorhinolaryngology. Although hemostasis can be achieved by outpatient treatment in many cases, we have also encountered some difficult-to-treat patients who developed rebleeding or required admission and surgery. We conducted a retrospective analysis of the clinical features of 615 patients with idiopathic epistaxis who were seen at our hospital between 2012 and 2019. We analyzed the patient data and clinical factors associated with epistaxis, including the age, gender, month (season) of visit to our hospital, accompanying systemic complications, bleeding points, procedures used for treatment, history of rebleeding, and history of hospitalization. The patients with epistaxis were predominantly males in their 70s. In regard to the season of presentation, patients with epistaxis were encountered more frequently in the winter than in the summer. Most patients had initially been treated by electrocoagulation. Hypertension was the most common underlying disease. Rebleeding within 7 days after the primary treatment occurred in 11.5% (71/615) of patients. Analysis identified heart and liver disease and antithrombotic drug use as significant risk factors for rebleeding. Although in the overall subject population the bleeding point was most frequently observed in Kiesselbach plexus area, the bleeding point was observed more often in the middle nasal meatus or olfactory cleft in the patients with rebleeding. The most common indication of hospitalization was difficulty in hemostasis, and the bleeding point in most of the hospitalized cases was unknown or in the posterior nasal cavity. The analysis revealed that it may be important to attempt endoscopic hemostasis in patients in whom the bleeding point is identified in the posterior nasal cavity.

Frequency and Etiology of Nosebleeds among Children in Pediatric Out-Patient Clinic of Ain Shams University Hospitals

Aims Measure frequency, severity, and etiology of epistaxis in a tertiary center pediatric out-patient clinic. Population Pediatric patients presented with epistaxis of an unknown cause. Methods Thorough clinical assessment, ENT examination CBC and coagulation profile and confirmatory tests when needed. Results 100 patients with epistaxis (53 females and 47 males) were recruited out of 30043 visits to pediatric OPC throughout one year (1 in 300). Most of them were younger than 12 and nearly half of them were younger than 6 years. 43 patients had epistaxis only, most probably local bleeding (37 had idiopathic epistaxis, 6 had local ENT cause). 57 had other bleeding manifestations, most probably systemic bleeding (47 had a definite bleeding disorder and 10 had undiagnosed bleeding tendency). There was a statistically significant higher number of patients with a positive family history for epistaxis and being referred from a primary care physician in those with probably systemic cause. Conclusion Epistaxis is not uncommon, it is not always idiopathic and can be the presenting symptom for an underlying bleeding tendency.

Aetiological profile of non-traumatic epistaxis: a two-year retrospective analysis in a tertiary care hospital

<p class="abstract"><strong>Background:</strong> Epistaxis is one of the commonest rhinological emergencies. Studies from different parts of the world show wide variation in aetiological profile. Idiopathic epistaxis is the most common form in most western studies while in many developing countries trauma is the predominant factor. Rhinosporidiosis is an important cause for epistaxis in certain parts of Malappuram district of Kerala. Hence this study was designed to analyze the non-traumatic causes for epistaxis in study location with a special emphasis on age and sex distribution and the role of rhinosporidium in epistaxis.</p><p class="abstract"><strong>Methods:</strong> Retrospective analysis of case records of epistaxis patients was done in a tertiary care teaching hospital in Malappuram district of Kerala, India. Patients with epistaxis reported through OP, IP and referrals from other departments were included as the study population. Age and sex distribution of idiopathic epistaxis and systemic and local cause of epistaxis with its age and sex distribution were analysed. </p><p class="abstract"><strong>Results:</strong> Total of 110 patients were studied, 74 males and 36 females, between the ages of 4 and 80. Predominant age group was 11-20 years followed by 21-30, with male dominance in almost all age ranges. Right side predominance was noted in unilateral cases. Thirty-six patients had primary epistaxis. Among the systemic causes, 15 had hypertension, four platelet dysfunction and three altered coagulation. Local causes were found in 51 cases; rhinosporidiosis being the commonest followed by infection.</p><p class="abstract"><strong>Conclusions:</strong> Non-traumatic epistaxis is more common among young males. Nasal rhinosporidiosis and infection are the two prominent local causes for epistaxis.</p>