Protocolo diagnóstico y terapéutico de la epistaxis

Abstract

Epistaxis arise more often in the Kisselbach's submucous arterial plexus, which is located at both sides in the anterior part of the nasal septum. Significantly less often, the pinpoint bleeding is in the back of the nostril, normally in a zone irrigated by the Sphenopalatine artery that leads to the posterolateral side of the nostril by the hole of the same name. Anterior epistaxis, that can be self-limiting, usually are controlled by simple manoeuvres as cauterizing the bleeding vessel or anterior packing. However, epistaxis originated at the back of the nostril often occur in middle-aged or elderly patients, with associated pathology. In posterior epistaxis cases, they usually require the placement of a pneumo-packing and, possibily, endoscopic cauterizing or clipping under general anaesthesia of the bleeding vessel, placing frequently a conventional posterior packing. Some cases are resolved by arterial embolization.