A Clinical Study of Etiopathogenesis And Management of Epistaxis

Introduction: Epistaxis is one of the commonest medical emergencies. It affects all age groups and both sexes. The areas for epistaxis are the Little’s area and the Woodruff’s plexus. The causes are divided into local or general causes. Trauma is considered to be a major etiological factor. Various treatment protocols are utilized to control epistaxis depending upon the type severity and cause of bleeding. The present work was undertaken to study the etiopathogenesis and management of epistaxis by non-surgical and surgical approaches. Material and Method: Fifty patients of both sexes and all age groups presenting to the Emergency Department or the ENT Outpatient Department at Rajendra Institute of Medical Sciences, Ranchi were taken up for the study. Priority was given to arrest the bleeding and to improve the general condition of the patient. Once the bleeding was controlled, detailed clinical examination and investigations were done to arrive at the diagnosis. Then the patient was given definite treatment depending upon the cause. Results: Males were affected twice more than females (1.9:1). The age distribution was bimodal with peaks below 20 years and above 40 years. The most common cause was found to be trauma followed by hypertension. Anterior nasal bleeding was noted in majority of the patients. 86% of the patients were managed by nonsurgical measures; only few (14%) requiring surgical intervention. Anterior nasal packing was the most effective method of controlling anterior epistaxis; while posterior bleeding was controlled by posterior nasal packing or with Foley’s catheter. Conclusion: Epistaxis has a bimodal age distribution and affects males more than females. Anterior bleeding is more common than posterior bleeding. Trauma is an important etiological factor followed by hypertension. Majority of cases are manageable by conservative measures and only few require surgical intervention.