Epistaxis differential diagnosis: Difference between revisions
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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]]. | 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]]. | ||
Rhinoscopy is the best way to distinguish between anterior and posterior [[epistaxis]] | Rhinoscopy is the best way to distinguish between anterior and posterior [[epistaxis]]. we can't find source of posterior-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]]:<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> | 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> | ||
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*[[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]] may cause [[cough]]<nowiki/> | *[[Posterior]] [[epistaxis]] may cause [[cough]]<nowiki/> and [[aspiration]]. | ||
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/}} <ref name="TunkelAnne2020" /> | 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/}} <ref name="TunkelAnne2020" /> | ||
Revision as of 22:57, 29 October 2020
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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. we can't find source of posterior-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 may 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) [2]
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 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.