EPISTAXIS

DR. JITENDRA. PATEL

doctorjitendra@yahoo.com
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 INTRODUCTION
• CAUSES : Ranging from insignificant trauma
to malignancy
• BLOOD LOSE :Ranging from few drops to
massive loss
• SITE : Anterior or Posterior

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 ETIOLOGY

CASUSES OF EPISTAXIS
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LOCAL CAUSES SYSTEMIC CAUSES IDIOPATHIC

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 LOCAL CAUSES
• 1) Congenital:
-Multiple telangiectases
• 2) Traumatic :
-Injury
-Post operative
-Picking

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 LOCAL CAUSES (Cont.)
• 3) Inflammatory:
ACUTE: -Vestibulitis
- Rhinitis
- Sinusitis
- Nasal diphtheria
CHRONIC: - Rhinitis
- Sinusitis
- T.B.,Syphilis,Lep
- Rhinosporidiosis
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 LOCAL CAUSES (Cont.)
• 4)Neoplasm: • 5)Miscellaneous:
-Angioma of septum -Foreign body
-Nasophar.Angiofibroma -Maggots/round worm
-Malignancy -Rhinolith
-Vicarious Menstruation

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 SYSTEMIC CAUSES
• 1) BLEEDING DIS. • 5) FEVER
• 2) HYPERTENSION • 6) DRUGS
• 3) PRESSURE IN • 7) UREMIA
SUP. VENA CAVA • 8) TOXEMIA
• 4) ATMOSPHERIC
PRESSURE

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 CLINICAL FEATURES
• 1) Ant. Rhinoscopy: site of bleeding:
-Nasal Septum – Mostly Little’s Area
-Inferior turbinate & nasal floor
-Middle turbinate
• 2) Post. Rhinoscopy
• 3) Quantity of blood loss
• 4) B.P.
• 5) Shock
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INVESTIGATIONS
• 1) Hb, TC, DC
• 2) X-Ray PNS OR CT
• 3) Biopsy
• 4) Nasal Endoscopy

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 TREATMENT

Rx of Specific Cause
First Aid
Local Rx
Systemic Rx
Surgical Rx
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Rx of Specific Cause

• 1) Removal of F.B.
• 2) Rx of Infective Rhinitis
• 3) Rx of Angioma like tumour
• 4) Rx of Maggots

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 First Aid
• 1) Pore cold water over head
• 2) Rub Ice cube over forehead and nose
• 3) Pinching of nose

• 4) Insert cotton plugwww.similima.com

inside nose 12
 Local Rx
• 1) Cauterisation

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 Local Rx
2) Ant. Packing

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 Local Rx (cont..)
• 3) Post Packing

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 Local Rx (cont..)
4) Folley’s Catheter insertion in nose

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 Systemic Rx

• 1) B.P.
• 2) B.T.
• 3) Shock
• 4) Coagulants ; Vit C, Vit K, Ca.
• 5) Antibiotic
• 6) Sedative

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 Surgical Rx

• 1) Ligation of Artery :
# Bleeding from upper part – ECA
# Bleeding from Lower part – Maxillary Ar.

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