Abstract

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. 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. 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. 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.

Highlights

  • Epistaxis is a common otolaryngological emergency but most of the cases are idiopathic

  • Epistaxis is very common in Nepal but there has not been a single study from Nepal that enrolls idiopathic cases only

  • Bleeding point was seen in 65 patients

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Summary

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. Epistaxis is a common symptom due to local or systemic conditions but with no identifiable cause in most cases. Epistaxis accounts for about 1 in 200 emergency visits in the United States[1] and incidence is not defined in most countries.[2] Epistaxis is very common in Nepal but there has not been a single study from Nepal that enrolls idiopathic cases only. Hypertension (HTN) has frequently been cited as a general risk factor for epistaxis. Severity of HTN and a history of epistaxis were not associated in a cohort of hypertensive patients.[3]

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