Epistaxis classification: Difference between revisions
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==Overview== | ==Overview== | ||
[[Epistaxis]] may be classified according to the anatomical origin of the bleeding into 2 groups: anterior and posterior. It can also be further classified into primary (if idiopathic) or secondary (if there is a known cause) and acute or chronic. | [[Epistaxis]] may be classified according to the anatomical origin of the [[bleeding]] into 2 groups: [[anterior]] and [[posterior]]. It can also be further classified into [[primary]] (if [[idiopathic]]) or [[secondary]] (if there is a known cause) and [[acute]] or [[chronic]]. | ||
==Classification== | ==Classification== | ||
===Classification according to anatomical source=== | ===Classification according to anatomical source=== | ||
[[Epistaxis]] can be classified into anterior and posterior based upon the anatomical source of bleeding<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> | [[Epistaxis]] can be classified into [[anterior]] and [[posterior]] based upon the anatomical source of [[bleeding]]<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> | ||
'''Anterior [[epistaxis]]''': | '''Anterior [[epistaxis]]''': | ||
* Anterior epistaxis is more common, and source of this bleeding is usually [[Kiesselbach's plexus]].<ref name="pmid29345234">{{cite journal| author=Beck R, Sorge M, Schneider A, Dietz A| title=Current Approaches to Epistaxis Treatment in Primary and Secondary Care. | journal=Dtsch Arztebl Int | year= 2018 | volume= 115 | issue= 1-02 | pages= 12-22 | pmid=29345234 | doi=10.3238/arztebl.2018.0012 | pmc=5778404 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29345234 }} </ref> | * [[Anterior]] [[epistaxis]] is more common, and source of this [[bleeding]] is usually [[Kiesselbach's plexus]].<ref name="pmid29345234">{{cite journal| author=Beck R, Sorge M, Schneider A, Dietz A| title=Current Approaches to Epistaxis Treatment in Primary and Secondary Care. | journal=Dtsch Arztebl Int | year= 2018 | volume= 115 | issue= 1-02 | pages= 12-22 | pmid=29345234 | doi=10.3238/arztebl.2018.0012 | pmc=5778404 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29345234 }} </ref> | ||
* Anterior epistaxis is easier to control with nasal compression, nasal packing and cautery. | * Anterior epistaxis is easier to control with nasal compression, [[nasal packing]] and [[cautery]]. | ||
'''Posterior-[[epistaxis]]:''' | '''Posterior-[[epistaxis]]:''' | ||
* Posterior [[bleeding]] is less common and harder to stop, and source of this [[bleeding]] is usually Woodruff's [[plexus]]. | * [[Posterior]] [[bleeding]] is less common and harder to stop, and source of this [[bleeding]] is usually [[Woodruff's]] [[plexus]]. | ||
* Woodruff's plexus is formed by vessels that are branches of the external carotid artery, thus, when it bleeds, it is usually much more severe than bleeding from Kiesselbach plexus' bleeding.<ref name="pmid29345234">{{cite journal| author=Beck R, Sorge M, Schneider A, Dietz A| title=Current Approaches to Epistaxis Treatment in Primary and Secondary Care. | journal=Dtsch Arztebl Int | year= 2018 | volume= 115 | issue= 1-02 | pages= 12-22 | pmid=29345234 | doi=10.3238/arztebl.2018.0012 | pmc=5778404 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29345234 }} </ref> | * [[Woodruff's plexus]] is formed by vessels that are branches of the [[external carotid artery]], thus, when it bleeds, it is usually much more severe than bleeding from Kiesselbach plexus' bleeding.<ref name="pmid29345234">{{cite journal| author=Beck R, Sorge M, Schneider A, Dietz A| title=Current Approaches to Epistaxis Treatment in Primary and Secondary Care. | journal=Dtsch Arztebl Int | year= 2018 | volume= 115 | issue= 1-02 | pages= 12-22 | pmid=29345234 | doi=10.3238/arztebl.2018.0012 | pmc=5778404 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29345234 }} </ref> | ||
* Bleeding from this plexus may cause [[aspiration]] and show [[bleeding]] with [[coughing]] and [[hemoptysis]]. | * [[Bleeding]] from this plexus may cause [[aspiration]] and show [[bleeding]] with [[coughing]] and [[hemoptysis]]. | ||
* This type of bleeding is more common in patients taking [[anticoagulants]] or [[hypertension]].<ref name="pmid28613768">{{cite journal| author=| title=StatPearls | journal= | year= 2020 | volume= | issue= | pages= | pmid=28613768 | doi= | pmc= | url= }} </ref> | * This type of [[bleeding]] is more common in patients taking [[anticoagulants]] or [[hypertension]].<ref name="pmid28613768">{{cite journal| author=| title=StatPearls | journal= | year= 2020 | volume= | issue= | pages= | pmid=28613768 | doi= | pmc= | url= }} </ref> | ||
===Classification according to time=== | ===Classification according to time=== | ||
* Acute epistaxis: as the name implies, it is a "de novo" bleeding. | * [[Acute]] epistaxis: as the name implies, it is a "de novo" [[bleeding]]. | ||
* Chronic epistaxis : it is characterized by intermittent bleeding, that persists through a period of time. | * [[Chronic]] epistaxis : it is characterized by intermittent [[bleeding]], that persists through a period of time. | ||
===Classification according to etiology=== | ===Classification according to etiology=== | ||
*Primary: it is classified as primary if the source of the bleeding isn't known. | *[[Primary]]: it is classified as [[primary]] if the source of the [[bleeding]] isn't known. | ||
* Secondary: it is classified as secondary if the bleeding is caused by another disease process (trauma, anticoagulants, arterial malformation). | * [[Secondary]]: it is classified as [[secondary]] if the [[bleeding]] is caused by another disease process ([[trauma]], [[anticoagulants]], [[arterial malformation]]). | ||
==References== | ==References== | ||
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{{WikiDoc Sources}} | {{WikiDoc Sources}} | ||
[[Category: | [[Category:Up-To-Date]] | ||
[[Category:Otolaryngology]] | [[Category:Otolaryngology]] | ||
[[Category:Rhinology]] | [[Category:Rhinology]] | ||
[[Category:First aid]] | [[Category:First aid]] | ||
[[Category:Injuries]] | [[Category:Injuries]] | ||
Latest revision as of 14:30, 3 December 2020
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Epistaxis Microchapters |
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Epistaxis classification On the Web |
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Risk calculators and risk factors for Epistaxis classification |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1],Associate Editor(s)-in-Chief: Amir Behzad Bagheri, M.D. José Eduardo Riceto Loyola Junior, M.D.[2]
Overview
Epistaxis may be classified according to the anatomical origin of the bleeding into 2 groups: anterior and posterior. It can also be further classified into primary (if idiopathic) or secondary (if there is a known cause) and acute or chronic.
Classification
Classification according to anatomical source
Epistaxis can be classified into anterior and posterior based upon the anatomical source of bleeding[1]
Anterior epistaxis:
- Anterior epistaxis is more common, and source of this bleeding is usually Kiesselbach's plexus.[2]
- Anterior epistaxis is easier to control with nasal compression, nasal packing and cautery.
Posterior-epistaxis:
- Posterior bleeding is less common and harder to stop, and source of this bleeding is usually Woodruff's plexus.
- Woodruff's plexus is formed by vessels that are branches of the external carotid artery, thus, when it bleeds, it is usually much more severe than bleeding from Kiesselbach plexus' bleeding.[2]
- Bleeding from this plexus may cause aspiration and show bleeding with coughing and hemoptysis.
- This type of bleeding is more common in patients taking anticoagulants or hypertension.[3]
Classification according to time
- Chronic epistaxis : it is characterized by intermittent bleeding, that persists through a period of time.
Classification according to etiology
- Secondary: it is classified as secondary if the bleeding is caused by another disease process (trauma, anticoagulants, arterial malformation).
References
- ↑ Krulewitz, Neil Alexander; Fix, Megan Leigh (2019). "Epistaxis". Emergency Medicine Clinics of North America. 37 (1): 29–39. doi:10.1016/j.emc.2018.09.005. ISSN 0733-8627.
- ↑ 2.0 2.1 Beck R, Sorge M, Schneider A, Dietz A (2018). "Current Approaches to Epistaxis Treatment in Primary and Secondary Care". Dtsch Arztebl Int. 115 (1–02): 12–22. doi:10.3238/arztebl.2018.0012. PMC 5778404. PMID 29345234.
- ↑ "StatPearls". 2020. PMID 28613768.