Epistaxis differential diagnosis
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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, 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 may cause coughing 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.