Clinical Profile of Idiopathic Epistaxis in a Hospital

Authors

  • R Bhatta Department of ENT, Nepalgunj Medical College Teaching Hospital, Banke

DOI:

https://doi.org/10.31729/jnma.254

Abstract

Introduction: Epistaxis is a common otolaryngological emergency but most of the cases are idiopathic. This study was done to assess clinical profile in patients with idiopathic epistaxis. 

Methods: Patients presenting in ENT outpatient department or emergency with epistaxis and no definite cause were selected. Patients demographic data, present and past history was recorded. All patients underwent anterior rhinoscopy and rigid nasal endoscopy. 

Results: There were 142 patients with epistaxis without definite cause. Age ranged from 11 to 84 years with mean 32.8 years. Approximately two-third were male. Bleeding from right side was seen in 64 (45.0%) patients. Past history of bleeding was given by 79 (55.6%) patients and out of them 60 (75.9) % had bleeding from same side. Presentation was mostly in months of January to March. Bleeding point was seen in 65 patients. Most of them (37/65) was in Little’s area. Deviated nasal septum was seen in 102 patients. More than half of patients with unilateral bleeding were having bleeding from convex side of deviation. Blood pressure was found to be equal or more than 140/90 mm Hg in 55 (38.7%) patients at the time of presentation. Antihypertensive was required in less than half of these patients. 

Conclusion: Idiopathic epistaxis is common in male, in winter season and in right side and from nasal septum. Hypertension may be found at presentation but most of them don’t need antihypertensive.

Keywords: deviated nasal septum; epistaxis; hypertension.

Author Biography

R Bhatta, Department of ENT, Nepalgunj Medical College Teaching Hospital, Banke

Lecturer, department of ENT/HNS, Nepalgunj Medical College

References

1. Pallin DJ, Chng YM, McKay MP, Emond JA, Pelletier AJ, Camargo CA Jr. Epidemiology of epistaxis in US emergency departments, 1992 to 2001. Ann Emerg Med. 2005 Jul;46(1):77-81.
2. VaamondeLago P, Martín Martín C, LechugaGarcía MR, MínguezBeltránI,Labella Caballero. Epidemiological notes on nasal bleeding. An Otorrinolaringol Ibero Am. 2004;31(2):123-32.
3. Lubianca-Neto JF, Bredemeier M, Carvalhal EF, Arruda CA, Estrella E, Pletsch A et al. A study of the association between epistaxis and the severity of hypertension. Am J Rhinol. 1998 Jul-Aug;12(4):269-72.
4. PinoRivero V, González Palomino A, Trinidad Ruiz G, Pardo Romero G, Marcos García M, Pantoja Hernández CGet al. Risk factors and clinical variables in patients hospitalized for epistaxis. Review of 200 patients. An Otorrinolaringol Ibero Am. 2005;32(3):229-37.
5. Stell PM. Epistaxis. Clin Otolaryngol.1977;2:263-73.
6. Akinpelu OV, Amusa YB, Eziyi JA, Nwawolo CC. A retrospective analysis of aetiology and management of epistaxis in a south-western Nigerian teaching hospital. West Afr J Med. 2009 May;28(3):165-8.
7. Lewandowski AS, Sliwińska-Kowalska M. Occurrence of epistaxis in relation to seasonal factors.Wiad Lek. 1993 Aug;46(15-16):597-602.
8. VaamondeLago P, LechugaGarcía MR, MínguezBeltrán I, Frade González C, Soto Varela A, BartualMagro J et al. Epistaxis: prospective study on emergency care at the hospital level.Acta Otorrinolaringol Esp. 2000 Nov-Dec;51(8):697-702.
9. Padgham N.Epistaxis:anatomical and clinic al correlates. Journal of laryngology and otology. 1990;104:308-11.
10. Fishpool SJ, Tomkinson A. Patterns of hospital admission with epistaxis for 26,725 patients over an 18-year period in Wales, UK. Ann R CollSurg Engl. 2012 Nov;94(8):559-62.
11. Tomkinson A, Roblin DG, Flanagan P, Quine SM, Backhouse S. Patterns of hospital attendance with epistaxis. Rhinology. 1997 Sep;35(3):129-31.
12. Razdan U, Zada R, Chaturvedi VN. Epistaxis: study of aetiology, site and side of bleeding.Indian J Med Sci. 1999 Dec;53(12):545-52.
13. Reiss M, Reiss G. Epistaxis: some aspects of laterality in 326 patients. Eur Arch Otorhinolaryngol. 2012 Mar;269(3):905-9.
14. McGarry GM. Epistaxis.In: Gleeson M, Brownng GG, Burton MJ et al. editors. Scott-Brown’s Otorhinolaryngology, Head and Neck surgery. Vol 1. 7th ed. Great Britain: Hodder Arnold Ltd, 2008. p. 1596-1606.
15. HartMJ,CowanDH. .The effect of ethanol on hemostatic properties of human blood platelets. Am J Med. 1974;56:22–33.
16. KlatskyAL, FriedmanGD, SieglaubAB, GerardMJ. Alcohol consumption and blood pressure: Kaiser-Permanente multiphasic health examination data. N Engl J Med. 1977;296:1194–2000.
17. Hasegawa T, Takegoshi H, Kikuchi S, Iinuma T. A statistical analysis of epistaxis between outpatients and inpatients.Nihon Jibiinkoka Gakkai Kaiho. 2004 Jan;107(1):18-24.
18. Nunez DA, Mcclymont LG, Evans RA. Epistaxis: a study of the relationship with weather. Clin otolaryngol.1990;15:49-51
19. Bray D, Giddings CE, Monnery P, Eze N, Lo S, Toma AG. Epistaxis: are temperature and seasonal variations true factors in incidence? J Laryngol Otol. 2005 Sep;119(9):724-6.

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Published

2012-12-31

How to Cite

Bhatta, R. (2012). Clinical Profile of Idiopathic Epistaxis in a Hospital. Journal of Nepal Medical Association, 52(188). https://doi.org/10.31729/jnma.254

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Original Article