Epistaxis differential diagnosis: Difference between revisions
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== Overview == | ==Overview== | ||
Many [[Disease|diseases]] can cause [[epistaxis]]. Based on patient history and [[physical examination]] we can [[diagnose]] cause of [[epistaxis]]. The challenging part is | Many [[Disease|diseases]] can cause [[epistaxis]]. Based on patient history and [[physical examination]] we can [[diagnose]] cause of [[epistaxis]]. The challenging part is [[differentiate]] [[anterior]]- [[epistaxis]] from [[posterior]]-[[epistaxis]]. | ||
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Rhinoscopy is the best way to distinguish between anterior and posterior [[epistaxis]], and we can't find source of bleeding with [[anterior]] [[rhinoscopy]].<br /> | |||
==Differentiating Epistaxis from other Diseases== | ==Differentiating Epistaxis from other Diseases== | ||
According to the following points, we can differentiate between anterior and posterior [[epistaxis]]: | According to the following points, we can differentiate between anterior and posterior [[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> <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 than posterior epistaxis, but posterior-epistaxis is harder to stop. | *Anterior [[epistaxis]] is more common than posterior epistaxis, but posterior-[[epistaxis]] is harder to [[Stopped flow|stop]]. | ||
* Causes of both anterior and posterior epistaxis are almost the same. | *Causes of both anterior and posterior [[epistaxis]] are almost the same. | ||
* Bleeding from | *Bleeding from [[Nostril|nostrils]] usually refers to anterior-[[epistaxis]] (it can occur in heavy [[posterior]]-[[epistaxis]] too). | ||
* Epistaxis in children is usually anterior but incidence of posterior epistaxis is more in elderly patients. | *[[Epistaxis]] in [[children]] is usually anterior but [[incidence]] of posterior [[epistaxis]] is more in [[elderly]] [[patients]]. | ||
* Rhinoscopy is the best way to distinguish between anterior and posterior epistaxis, and we can't find source of bleeding with anterior rhinoscopy. | *[[Rhinoscopy]] is the best way to [[distinguish]] between anterior and posterior [[epistaxis]], and we can't find source of [[bleeding]] with [[anterior]] [[rhinoscopy]]. | ||
*[[Posterior]] [[epistaxis]] can cause [[cough]] and [[aspiration]]. | |||
Following causes of epistaxis are | Following causes of [[epistaxis]] are important [[causes]] that we should differentiate them:{{Cite web|url=https://www.ncbi.nlm.nih.gov/books/NBK435997/|title=Epistaxis (Nose Bleed)|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=https://www.ncbi.nlm.nih.gov/books/NBK435997/}} | ||
* [[Nasal tumor]] | |||
* [[Disseminated intravascular coagulation|DIC]] | |||
* [[Hemophilia]] | |||
* [[Rhinitis]] | |||
* [[Foreign body]] in the nose | |||
* [[Drug toxicity]] | |||
* [[Von Willebrand disease]] | |||
* | * | ||
==References== | ==References== | ||
Revision as of 20:38, 14 October 2020
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Epistaxis differential diagnosis On the Web |
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Risk calculators and risk factors for Epistaxis differential diagnosis |
Editor in Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Amir Behzad Bagheri, M.D.
Overview
Many diseases can cause epistaxis. Based on patient history and physical examination we can diagnose cause of epistaxis. The challenging part is differentiate anterior- epistaxis from posterior-epistaxis.
Rhinoscopy is the best way to distinguish between anterior and posterior epistaxis, and we can't find source of bleeding with anterior rhinoscopy.
Differentiating Epistaxis from other Diseases
According to the following points, we can differentiate between anterior and posterior epistaxis:[1] [2]
- Anterior epistaxis is more common than posterior epistaxis, but posterior-epistaxis is harder to stop.
- Causes of both anterior and posterior epistaxis are almost the same.
- Bleeding from nostrils usually refers to anterior-epistaxis (it can occur in heavy posterior-epistaxis too).
- Epistaxis in children is usually anterior but incidence of posterior epistaxis is more in elderly patients.
- Rhinoscopy is the best way to distinguish between anterior and posterior epistaxis, and we can't find source of bleeding with anterior rhinoscopy.
- Posterior epistaxis can cause cough and aspiration.
Following causes of epistaxis are important causes that we should differentiate them:"Epistaxis (Nose Bleed)". Retrieved https://www.ncbi.nlm.nih.gov/books/NBK435997/. Check date values in: |access-date= (help)
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.
- ↑ 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.