What is epistaxis?

Updated: May 09, 2018
  • Author: Eric Goralnick, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Epistaxis is a common problem in the emergency department (ED). Generally, it is relatively benign, but it can sometimes produce serious, life-threatening situations. Up to 60% of the population is estimated to have had at least 1 episode of epistaxis at some point in their lives. Of this group, 6% seek medical care to treat epistaxis, with 1.6 in 10,000 requiring hospitalization. [1]

Most cases of epistaxis occur in children younger than 10 years. Epistaxis is more common in colder seasons and in northern climates because of decreased humidity and the consequent drying of the nasal mucosa. [2] Other major etiologies include inhaled medications, mucosal breakdown caused by infiltration by malignancy or granulomatous disease, and nasal trauma.

Ninety percent of epistaxes are anterior, originating from the Kiesselbach plexus (see the image below). Anterior epistaxes exhibit unilateral, steady, nonmassive bleeding. Just 10% of epistaxes are posterior, exhibiting massive bleeding that is initially bilateral.

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