Epistaxis diagnostic study of choice: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
(Created page with "==Pathophysiology== Different causes tear vessels of nose plexuses and motive epistaxis:<ref name="KrulewitzFix2019">{{cite journal|last1=Krulewitz|first1=Neil Alexander|last2...")
 
No edit summary
Line 1: Line 1:
==Pathophysiology==
== Overview ==
Different causes tear vessels of nose plexuses and motive epistaxis:<ref name="KrulewitzFix2019">{{cite journal|last1=Krulewitz|first1=Neil Alexander|last2=Fix|first2=Megan Leigh|title=Epistaxis|journal=Emergency Medicine Clinics of North America|volume=37|issue=1|year=2019|pages=29–39|issn=07338627|doi=10.1016/j.emc.2018.09.005}}</ref>{{Cite web|url=https://www.ncbi.nlm.nih.gov/books/NBK430685/|title=Epistaxis (Nose Bleed)|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}
The diagnostic study of choice to find the source of epistaxis is rhinoscopy. In patients which rhinoscopy is not efficient to find the source vessel of bleeding,  internal carotid artery (ICA) angiography is the most efficient action to find the bleeding site.


*Epistaxis is due to tears in the mucosal lining and the many small blood vessels it contains. It can start by trauma, nasal picking, coagulopathies tumors or spontaneous.
==Diagnostic study of choice==
*There is not enough evidence that [[hypertension]] is a [[risk factor]] for [[epistaxis]]. The role of lowering [[blood pressure]] to control and prevent [[epistaxis]] remains controversial.
The diagnostic study of choice to find the source of epistaxis is rhinoscopy. In patients which rhinoscopy is not efficient to find vessel which bleeding, internal carotid artery (ICA) angiography is the most efficient action to find the bleeding site.<ref name="KrajinaChrobok2013">{{cite journal|last1=Krajina|first1=Antonín|last2=Chrobok|first2=Viktor|title=Radiological Diagnosis and Management of Epistaxis|journal=CardioVascular and Interventional Radiology|volume=37|issue=1|year=2013|pages=26–36|issn=0174-1551|doi=10.1007/s00270-013-0776-y}}</ref><ref name="TunkelAnne2020">{{cite journal|last1=Tunkel|first1=David E.|last2=Anne|first2=Samantha|last3=Payne|first3=Spencer C.|last4=Ishman|first4=Stacey L.|last5=Rosenfeld|first5=Richard M.|last6=Abramson|first6=Peter J.|last7=Alikhaani|first7=Jacqueline D.|last8=Benoit|first8=Margo McKenna|last9=Bercovitz|first9=Rachel S.|last10=Brown|first10=Michael D.|last11=Chernobilsky|first11=Boris|last12=Feldstein|first12=David A.|last13=Hackell|first13=Jesse M.|last14=Holbrook|first14=Eric H.|last15=Holdsworth|first15=Sarah M.|last16=Lin|first16=Kenneth W.|last17=Lind|first17=Meredith Merz|last18=Poetker|first18=David M.|last19=Riley|first19=Charles A.|last20=Schneider|first20=John S.|last21=Seidman|first21=Michael D.|last22=Vadlamudi|first22=Venu|last23=Valdez|first23=Tulio A.|last24=Nnacheta|first24=Lorraine C.|last25=Monjur|first25=Taskin M.|title=Clinical Practice Guideline: Nosebleed (Epistaxis)|journal=Otolaryngology–Head and Neck Surgery|volume=162|issue=1_suppl|year=2020|pages=S1–S38|issn=0194-5998|doi=10.1177/0194599819890327}}</ref>
*Anterior epistaxis is more common, and source of this bleeding is usually Kiesselbach's plexus.
<ref name="ChaabanZhang2016">{{cite journal|last1=Chaaban|first1=Mohamad R.|last2=Zhang|first2=Dong|last3=Resto|first3=Vicente|last4=Goodwin|first4=James S.|title=Demographic, Seasonal, and Geographic Differences in Emergency Department Visits for Epistaxis|journal=Otolaryngology–Head and Neck Surgery|volume=156|issue=1|year=2016|pages=81–86|issn=0194-5998|doi=10.1177/0194599816667295}}</ref> <ref name="BéquignonTeissier2017">{{cite journal|last1=Béquignon|first1=E|last2=Teissier|first2=N|last3=Gauthier|first3=A|last4=Brugel|first4=L|last5=De Kermadec|first5=H|last6=Coste|first6=A|last7=Prulière-Escabasse|first7=V|title=Emergency Department care of childhood epistaxis|journal=Emergency Medicine Journal|volume=34|issue=8|year=2017|pages=543–548|issn=1472-0205|doi=10.1136/emermed-2015-205528}}</ref>
*Posterior bleeding is less common and harder to stop, and source of this bleeding is usually Woodruff's plexus. Bleeding from this plexus may cause aspiration and show bleeding with coughing and hemoptysis.
 
 
* In posterior epistaxis, posterior rhinoscopy is needed to find the source of bleeding.


<br />
<br />
<references />

Revision as of 21:10, 28 October 2020

Overview

The diagnostic study of choice to find the source of epistaxis is rhinoscopy. In patients which rhinoscopy is not efficient to find the source vessel of bleeding, internal carotid artery (ICA) angiography is the most efficient action to find the bleeding site.

Diagnostic study of choice

The diagnostic study of choice to find the source of epistaxis is rhinoscopy. In patients which rhinoscopy is not efficient to find vessel which bleeding, internal carotid artery (ICA) angiography is the most efficient action to find the bleeding site.[1][2] [3] [4]


  • In posterior epistaxis, posterior rhinoscopy is needed to find the source of bleeding.


  1. ↑ Krajina, Antonín; Chrobok, Viktor (2013). "Radiological Diagnosis and Management of Epistaxis". CardioVascular and Interventional Radiology. 37 (1): 26–36. doi:10.1007/s00270-013-0776-y. ISSN 0174-1551.
  2. ↑ Tunkel, David E.; Anne, Samantha; Payne, Spencer C.; Ishman, Stacey L.; Rosenfeld, Richard M.; Abramson, Peter J.; Alikhaani, Jacqueline D.; Benoit, Margo McKenna; Bercovitz, Rachel S.; Brown, Michael D.; Chernobilsky, Boris; Feldstein, David A.; Hackell, Jesse M.; Holbrook, Eric H.; Holdsworth, Sarah M.; Lin, Kenneth W.; Lind, Meredith Merz; Poetker, David M.; Riley, Charles A.; Schneider, John S.; Seidman, Michael D.; Vadlamudi, Venu; Valdez, Tulio A.; Nnacheta, Lorraine C.; Monjur, Taskin M. (2020). "Clinical Practice Guideline: Nosebleed (Epistaxis)". Otolaryngology–Head and Neck Surgery. 162 (1_suppl): S1–S38. doi:10.1177/0194599819890327. ISSN 0194-5998.
  3. ↑ Chaaban, Mohamad R.; Zhang, Dong; Resto, Vicente; Goodwin, James S. (2016). "Demographic, Seasonal, and Geographic Differences in Emergency Department Visits for Epistaxis". Otolaryngology–Head and Neck Surgery. 156 (1): 81–86. doi:10.1177/0194599816667295. ISSN 0194-5998.
  4. ↑ Béquignon, E; Teissier, N; Gauthier, A; Brugel, L; De Kermadec, H; Coste, A; Prulière-Escabasse, V (2017). "Emergency Department care of childhood epistaxis". Emergency Medicine Journal. 34 (8): 543–548. doi:10.1136/emermed-2015-205528. ISSN 1472-0205.
Retrieved from "https://www.wikidoc.org/index.php?title=Epistaxis_diagnostic_study_of_choice&oldid=1672551"