Epistaxis differential diagnosis: Difference between revisions

Jump to navigation Jump to search
No edit summary
No edit summary
Line 2: Line 2:
{{Epistaxis}}
{{Epistaxis}}
'''Editor in Chief''': [[User:C Michael Gibson|C. Michael Gibson, M.S., M.D.]] [1] '''Associate Editor(s)-in-Chief:''' [[User:Amir Bagheri|Amir Behzad Bagheri, M.D.]]
'''Editor in Chief''': [[User:C Michael Gibson|C. Michael Gibson, M.S., M.D.]] [1] '''Associate Editor(s)-in-Chief:''' [[User:Amir Bagheri|Amir Behzad Bagheri, M.D.]]
<br />


==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 [[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]]. In selected cases, endoscopy may be required.


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>  
[[Epistaxis]] can be differentiated 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 [[Stopped flow|stop]].
*Anterior [[epistaxis]] is more common than posterior epistaxis, but posterior-[[epistaxis]] is harder to [[Stopped flow|stop]].
*Anterior and posterior [[epistaxis]] can be differentiated during clinical management, as anterior epistaxis is much more easily controlled. In case of refractory or profuse bleeding, suspect of posterior [[epistaxis]].
 
*Causes of both anterior and posterior [[epistaxis]] are almost the same.
*Causes of both anterior and posterior [[epistaxis]] are almost the same.
 
*Bleeding from [[Nostril|nostrils]] usually refers to anterior [[epistaxis]] (it can occur in heavy [[posterior]] [[epistaxis]] too).
*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 common in [[elderly]] [[patients]].
 
*[[Rhinoscopy]] is the best way to [[distinguish]] between anterior and posterior [[epistaxis]], in the case of not finding the source of [[bleeding]] with [[anterior]] [[rhinoscopy]], treatment for posterior epistaxis must be started.
*[[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]]<nowiki/> and [[aspiration]].
*[[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" />
The more common and important causes of epistaxis are listed below:<ref name="pmid28613768">{{cite journal| author=| title=StatPearls | journal= | year= 2020 | volume= | issue= | pages= | pmid=28613768 | doi= | pmc= | url= }} </ref>
 
*[[Nasal tumor]]
*[[Nasal tumor]]
*[[Disseminated intravascular coagulation|DIC]]
*[[Disseminated intravascular coagulation|DIC]]
Line 31: Line 25:
*[[Drug toxicity]]
*[[Drug toxicity]]
*[[Von Willebrand disease]]
*[[Von Willebrand disease]]
*


==References==
==References==

Revision as of 23:43, 29 October 2020

Epistaxis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Epistaxis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT Scan

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Epistaxis differential diagnosis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Epistaxis differential diagnosis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Epistaxis differential diagnosis

CDC on Epistaxis differential diagnosis

Epistaxis differential diagnosis in the news

Blogs on Epistaxis differential diagnosis

Directions to Hospitals Treating Epistaxis

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. In selected cases, endoscopy may be required.

Differentiating Epistaxis from other Diseases

Epistaxis can be differentiated between anterior and posterior epistaxis.[1] [2]

The more common and important causes of epistaxis are listed below:[3]

References

  1. 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. 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.
  3. "StatPearls". 2020. PMID 28613768.

Template:WikiDoc Sources